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目的研究脓毒症患者血浆中miR-146a的表达,评价其对脓毒症早期诊断的价值。方法采集脓毒症患者(脓毒症组,30例)及同期进行体检的健康人员(健康对照组,20例)的血标本。采用实时荧光定量PCR(RTqPCR)检测血浆miR-146a水平;检测降钙素原(PCT)、C反应蛋白(CRP)水平,并记录APACHEⅡ评分。采用受试者工作特征(ROC)曲线评价血浆miR-146a、PCT、CRP对脓毒症的预测价值;分析miR-146a的表达与PCT、CRP及APACHEⅡ评分的相关性。结果脓毒症组miR-146a的表达倍数明显高于健康对照组[(7.03±3.17)比(2.39±1.47),P<0.05],PCT及CRP含量、APACHEⅡ评分亦高于健康对照组(均P<0.05);且miR-146a与PCT、CRP及APACHEⅡ评分呈正相关(r分别为0.767、0.797、0.672)。miR-146a诊断脓毒症的敏感性和特异性分别为86.67%、45.00%,ROC曲线下面积(AUC)为0.898。结论血浆miR-146a对脓毒症的早期诊断指标具有较高的敏感性及特异性。
Objective To study the expression of miR-146a in plasma of patients with sepsis and evaluate its value in the early diagnosis of sepsis. Methods Blood samples of sepsis patients (sepsis group, 30 cases) and healthy subjects (control group, 20 cases) were collected during the same period. Real-time quantitative PCR (RTqPCR) was used to detect the level of plasma miR-146a. The levels of procalcitonin (PCT) and C-reactive protein (CRP) were measured and APACHEⅡscore was recorded. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of plasma miR-146a, PCT and CRP in sepsis. The correlation between miR-146a expression and PCT, CRP and APACHEⅡ scores was analyzed. Results The expression of miR-146a in sepsis group was significantly higher than that in healthy controls [(7.03 ± 3.17) vs (2.39 ± 1.47, P <0.05]. PCT and CRP levels and APACHEⅡ scores were also higher than those in healthy controls P <0.05). There was a positive correlation between miR-146a and PCT, CRP and APACHEⅡ scores (r = 0.767,0.797,0.672, respectively). The sensitivity and specificity of miR-146a in diagnosing sepsis were 86.67% and 45.00%, respectively. The area under the curve of ROC (AUC) was 0.898. Conclusion Plasma miR-146a has high sensitivity and specificity for the early diagnosis of sepsis.