老年重症肺部感染MicroRNAs表达水平及其对预后的评估价值

Expression levels of MicroRNAs in elderly patients with severe pulmonary infection and their values in prediction of prognosis

    摘要
  • 摘要: 目的 分析老年重症肺部感染患者预后危险因素及微小核糖核酸-127(miR-127)、miR-146a、miR-125b、miR-495-3p预测老年重症肺部感染预后的价值。方法 选取2020年1月-2022年4月海南医学院第一附属医院收治的老年重症肺部感染患者124例纳入研究,根据患者28 d内临床结局分为死亡组31例和生存组93例,回顾性收集患者临床资料,单因素及多因素Logistic回归分析老年重症肺部感染预后的危险因素,绘制受试者工作特征(ROC)曲线分析miR-127、miR-146a、miR-125b、miR-495-3p对老年重症肺部感染预后的预测价值。结果 124例重症肺部感染患者28 d内死亡31例,病死率为25.00%。多因素Logistic分析结果显示,高龄、基础疾病≥3种、侵入性操作为老年重症肺部感染死亡的危险因素(P＜0.05)。与生存组比较,死亡组miR-127、miR-146a、miR-125b表达水平升高,miR-495-3p表达水平降低(P＜0.05)。ROC曲线结果显示,miR-127、miR-146a、miR-125b、miR-495-3p联合对老年重症肺部感染死亡的诊断价值较高,曲线下面积(AUC)、灵敏度、特异度分别为0.936、87.10%、94.36%。结论 老年重症肺部感染患者预后较差,高龄、基础疾病≥3种、侵入性操作为老年重症肺部感染死亡的危险因素,miR-127、miR-146a、miR-125b、miR-495-3p检测均对老年重症肺部感染的死亡具有良好的预测价值。

     

    Abstract: OBJECTIVE To explore the risk factors for prognosis of the elderly patients with severe pulmonary infection and analyze the clinical values of micro ribonucleic acid -127 (miR-127), micro ribonucleic acid-146 a (miR-146 a), micro ribonucleic acid-125 b (miR-125 b) and micro ribonucleic acid-495-3p (miR-495-3p) in prediction of prognosis of the patients. METHODS A total of 124 elderly patients with severe pulmonary infection who were treated in the First Affiliated Hospital of Hainan Medical College from Jan 2020 to Apr 2022 were enrolled in the study and were divided into the death group with 31 cases and the survival group with 93 cases according to the 28-day clinical treatment outcomes. The clinical data were retrospectively collected from the patients, univariate analysis and multivariate logistic regression analysis were performed for risk factors for the prognosis of the elderly patients with severe pulmonary infection, and the values of miR-127, miR-146 a, miR-125 b and miR-495-3p in prediction of the prognosis of the elderly patients with severe pulmonary infection were analyzed by means of receiver operating characteristic (ROC) curves. RESULTS Among the 124 patients with severe pulmonary infection, 31 died within 28 days, with the mortality rate 25.00%. The result of multivariate logistic analysis showed that the advanced age, no less than 3 types of underlying diseases and invasive procedures were the risk factors for death of the elderly patients with severe pulmonary infection(P＜0.05). The expression levels of miR-127, miR-146 a and miR-125b of the death group were higher than those of the survival group, while the expression level of miR-495-3p of the death group was lower than that of the survival group(P＜0.05). ROC curve analysis indicated that the value of the joint detection of miR-127, miR-146a, miR-125b and miR-495-3p was high in diagnosis of death of the elderly patients with severe pulmonary infection, with the area under curve (AUC) 0.936, the sensitivity 87.10%, the specificity 94.36%. CONCLUSION The elderly patients with severe pulmonary infection have poor prognosis. The advanced age, no less than 3 types of underlying diseases and invasive procedures are the risk factors for death of the elderly patients with severe pulmonary infection. miR-127, miR-146a, miR-125b and miR-495-3p have high value in prediction of death of the elderly patients with severe pulmonary infection.

     

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