血清miR-15a、miR-34b、PCT/ALB联合检测在血液透析患者导管相关性血流感染早期诊断中的应用价值OA

Objective:Catheter-related bloodstream infection(CRBSI)is a common and serious complication in hemodialysis patients.Early diagnosis and timely treatment are beneficial for controlling disease progression and improving patient prognosis.In recent years,serum biomarkers have been widely used for the early diagnosis of various clinical diseases.MicroRNAs(miRNAs)are involved in the occurrence and progression of multiple diseases and participate in the regulation of immune response during infectious diseases.The procalcitonin-to-albumin ratio(PCT/ALB)reflects the infection status of the body.This study aims to investigate the value of combined detection of serum miR-15a,miR-34b,and PCT/ALB in the early diagnosis of CRBSI in hemodialysis patients. Methods:A total of 96 hemodialysis patients admitted to Zhengzhou People's Hospital from March 2025 to March 2026 were enrolled.Serum miR-15a and miR-34b expression levels were detected using real-time reverse transcription PCR(real-time RT-PCR).Serum procalcitonin(PCT)and albumin(ALB)levels were measured using an automated biochemical analyzer,and the PCT/ALB ratio was calculated.According to the occurrence of CRBSI,patients were divided into an infection group and a non-infection group.The differences in serum miR-15a,miR-34b,and PCT/ALB levels between the 2 groups were compared.Pearson correlation analysis was performed to evaluate the associations between serum miR-15a,miR-34b,PCT/ALB levels,and the occurrence of CRBSI.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic performance of miR-15a,miR-34b,PCT/ALB,and their combination for CRBSI in hemodialysis patients. Results:Among the 96 hemodialysis patients,20 patients developed CRBSI(infection group),while 76 patients did not(non-infection group).No significant differences were observed in baseline characteristics,including sex,age,duration of uremia,dialysis duration,and antibiotic use,between the 2 groups(all P>0.05).Serum miR-15a expression was significantly lower in the infection group(0.48±0.05)than in the non-infection group(0.56±0.08,P<0.001).Serum miR-34b expression(0.61±0.09)and PCT/ALB levels(1.96±0.31)were significantly higher in the infection group than in the non-infection group(0.52±0.07 and 1.65±0.24,respectively;both P<0.001).Serum miR-15a expression was negatively correlated with the occurrence of CRBSI in hemodialysis patients(r=-0.455,P<0.001),whereas miR-34b and PCT/ALB levels were positively correlated with CRBSI occurrence(r=0.550 and 0.460,respectively;both P<0.001).The areas under the curve(AUCs)of serum miR-15a,miR-34b,PCT/ALB,and their combined detection for diagnosing CRBSI were 0.773,0.809,0.762,and 0.920,respectively.The AUC of the combined diagnostic model was significantly higher than that of each individual marker(all P<0.05).The specificity of the combined diagnosis(93.42%)was higher than that of miR-15a(71.05%),miR-34b(68.42%),and PCT/ALB(72.37%)alone.The sensitivity of the combined diagnosis(75.00%)was slightly lower than that of miR-15a(80.00%)and miR-34b(85.00%),but was comparable to that of PCT/ALB(75.00%). Conclusion:Hemodialysis patients complicated with CRBSI exhibited increased serum miR-34b and PCT/ALB levels and decreased miR-15a expression.All 3 biomarkers were associated with CRBSI occurrence in hemodialysis patients,and their combined detection showed superior early diagnostic performance compared with individual markers.Serum miR-15a,miR-34b,and PCT/ALB levels may serve as potential indicators for early assessment of CRBSI risk in hemodialysis patients and provide guidance for early clinical intervention.