血清微小核糖核酸-133a、微小核糖核酸-126、髓系细胞表达触发受体-1、肺表面活性蛋白A表达水平与脓毒症并发急性呼吸窘迫综合征风险及预后关系OACSTPCD

Objective:To investigate the relationship between the expression levels of serum microRNA-133a(miR-133a).microRNA-126(miR-126),myeloid cell expression triggering receptor-1(TREM-1),pulmonary surfac-tant protein A(SP-A)and the risk and prognosis of acute respiratory distress syndrome(ARDS)complicated by sepsis.Methods:248 patients with sepsis were divided into a group without ARDS(97 cases)and a group with ARDS(151 cases)according to whether they had ARDS.Serum expression levels of miR-133a,miR-126,TREM-1 and SP-A in the two groups were analyzed.According to the severity of sepsis complicated with ARDS and the prognosis 28 d after admission,the patients were divided into the mild group(51 cases),the moderate group(73 cases),the se-vere group(27 cases)and the survival group(122 cases),the death group(29 cases).To compare the expression levels of miR-133a,miR-126,TREM-1 and SP-A in serum of ARDS patients with sepsis complicated with different severity and prognosis.The predictive value of serum miR-133a,miR-126,TREM-1 and SP-A on the prognosis of ARDS patients with sepsis was analyzed by receiver operating characteristic curve(ROC).Results:The expression levels of miR-133a,miR-126 and TREM-1 in the non-ARDS group were higher than those in the ARDS group,and the expression level of SP-A in the ARDS group was lower than that in the non-ARDS group(all P＜0.05).The ex-pression levels of serum miR-133a,miR-126 and TREM-1 in the mild groups,the moderate groups and the severe groups were increased,while the expression level of serum SP-A was decreased(all P＜0.05).The expression levels of serum miR-133a,miR-126 and TREM-1 in the death group were higher than those in the survival group,and the expression level of serum SP-A was lower than that in the survival group(all P＜0.05).The area under the curve(AUC)value of serum miR-133a,miR-126,TREM-1 and SP-A combined to predict prognosis of ARDS patients with sepsis was higher than that of the four alone(all P＜0.05).Sensitivity comparison showed that serum SP-A and TREM-1 were higher than serum miR-133a,miR-126 and combination,and serum SP-A was higher than serum TREM-1 and combined with serum miR-133a and miR-126(all P＜0.05).The specificity of serum miR-133a was higher than that of serum TREM-1,SP-A and combination,and that of serum miR-126 and combination was higher than that of serum TREM-1 and SP-A(all P＜0.05).Conclusion:The expression levels of serum miR-133a,miR-126,TREM-1 and SP-A are closely related to the occurrence and development of sepsis complicated with ARDS patients,and the combination of the four have a good predictive effect on the prognosis of sepsis complicated with ARDS patients.