检验医学与临床2025，Vol.22Issue(10)：1338-1342,1349,6.DOI:10.3969/j.issn.1672-9455.2025.10.009
脓毒症并发急性肾损伤患者血清miR-21-3p、miR-29a水平与病情严重程度的关系及对患者死亡的预测价值
Relationship between serum miR-21-3p and miR-29a levels and the severity of sepsis patients with acute kidney injury and its predictive value for the death of patients
摘要
Abstract
Objective To investigate the relationship between serum microRNA(miR)-21-3p and miR-29a levels and the severity of sepsis in patients with acute kidney injury(AKI)and its predictive value for the death of patients.Methods A total of 126 patients with sepsis complicated with AKI admitted to the hospital from March 2022 to March 2024 were selected as the disease group,and were divided into stage Ⅰ group(49 cases),stage Ⅱ group(42 cases)and stage Ⅲ group(35 cases)according to the AKI staging criteria.Accord-ing to the prognosis after 28 d of treatment,the patients who died in the disease group were included in the death group,and the patients who survived were included in the survival group.Another 110 patients with simple sepsis admitted to the hospital were selected as the control group.The levels of serum miR-21-3p and miR-29a were detected by real-time fluorescence quantitative polymerase chain reaction.Multivariate Logistic regression was used to analyze the influencing factors of death in patients with sepsis complicated with AKI.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum miR-21-3p,miR-29a alone and combined detection for death in patients with sepsis complicated by AKI.Results The lev-els of serum miR-21-3p and miR-29a in the disease group were significantly higher than those in the control group,and the differences were statistically significant(P＜0.05).The levels of serum miR-21-3p and miR-29a in the stage Ⅲ group were significantly higher than those in the stage Ⅱ group and the stage Ⅰ group,and the stage Ⅱ group was higher than the stage Ⅰ group,and the differences were statistically significant(P＜0.05).There were 76 patients in the survival group and 50 patients in the death group.The levels of ser-um miR-21-3p,miR-29a,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and serum creatinine level in the death group were higher than those in the survival group,and the differences were sta-tistically significant(P＜0.05).Multivariate Logistic regression analysis showed that APACHE Ⅱ score,miR-21-3p and miR-29a were the influencing factors of death in sepsis patients with AKI(P＜0.05).ROC curve a-nalysis showed that the area under the curve(AUC)of serum miR-21-3p,miR-29a and their combination for predicting the death of sepsis patients with AKI were 0.774,0.789 and 0.888 respectively.The AUC of com-bined detection in predicting the death of sepsis patients with AKI was greater than that of each single detec-tion(Zcombined with miR-21-3p=2.829,Zcombined with miR-29a=2.509,Pcombined with miR-21-3p=0.005,Pcombined with miR-29a=0.012).Conclusion The levels of serum miR-21-3p and miR-29a in patients with sepsis complicated with AKI are sig-nificantly increased,which are closely related to the severity of the disease and prognosis.The combined detec-tion of the two has a better predictive effect on the prognosis of patients with sepsis complicated with AKI.关键词
微小RNA-21-3p/微小RNA-29a/脓毒症急性肾损伤/病情严重程度/预后Key words
microRNA-21-3p/microRNA-29a/septic acute kidney injury/severity of illness/prognosis分类
医药卫生引用本文复制引用
李丹,葛佳奇,尹雯悦,王寅..脓毒症并发急性肾损伤患者血清miR-21-3p、miR-29a水平与病情严重程度的关系及对患者死亡的预测价值[J].检验医学与临床,2025,22(10):1338-1342,1349,6.基金项目
江苏省无锡市中医药科技项目(ZYYB26). （ZYYB26）
