急性呼吸窘迫综合征合并肺部感染血清NLRP3 mRNA、miR-155-5p、miR-98-5p表达及临床意义

Expressions of serum NLRP3 mRNA, miR-155-5p and miR-98-5p in acute respiratory distress syndrome patients complicated with pulmonary infection and clinical significance

    摘要
  • 摘要:
    目的 分析急性呼吸窘迫综合征(ARDS)合并肺部感染血清核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)mRNA、微小核糖核酸(miR)-155-5p、miR-98-5p表达及临床意义。
    方法 将2020年1月-2023年5月潍坊医学院附属医院收治的ARDS合并肺部感染患者104例纳入感染组(其中轻度组40例、中度组39例和重度组25例，入院28 d死亡31例)，ARDS未合并肺部感染患者105例纳入未感染组。分析两组临床资料，比较两组、不同病情、不同预后ARDS合并肺部感染患者血清NLRP3 mRNA、miR-155-5p、miR-98-5p表达水平，绘制受试者工作特征(ROC)曲线分析血清NLRP3 mRNA、miR-155-5p、miR-98-5p表达水平单独及联合检测对ARDS合并肺部感染患者预后的预测价值。
    结果 相较未感染组，感染组血清NLRP3 mRNA、miR-155-5p表达水平升高，而血清miR-98-5p表达水平降低(P < 0.05)。轻、中和重度组血清NLRP3 mRNA、miR-155-5p表达水平呈升高趋势，血清miR-98-5p表达水平呈降低趋势(P < 0.05)。相较预后良好组，预后不良组血清NLRP3 mRNA、miR-155-5p表达水平更高，血清miR-98-5p表达水平更低(P < 0.05)。绘制ROC曲线, 血清NLRP3 mRNA、miR-155-5p、miR-98-5p表达水平联合检测对ARDS合并肺部感染预后的预测价值较高(P < 0.05)，曲线下面积(AUC)为0.899。
    结论 ARDS合并肺部感染患者肺部感染程度、ARDS病情加重与血清NLRP3 mRNA、miR-155-5p、miR-98-5p表达密切相关，联合检测对ARDS合并肺部感染患者预后具有良好的预测。

     

    Abstract:
    OBJECTIVE To investigate the expressions of serum nucleotide-binding oligomeric domain-like receptor protein 3 (NLRP3) mRNA, micro ribonucleic acid (miR) -155-5p and miR-98-5p in the acute respiratory distress syndrome (ARDS) patients complicated with pulmonary infection and analyze the clinical significance.
    METHODS A total of 104 ARDS patients complicated with pulmonary infection who were treated in Weifang Medical College Affiliated Hospital from Jan. 2020 to May 2023 were assigned as the infection group (the mild group with 40 cases, the moderate group with 39 cases, the severe group with 25 cases, 31 cases died within 28 days after the admission to hospital). Totally 105 ARDS patients without pulmonary infection were chosen as the no infection group. The clinical data of the two groups of patients were analyzed. The expression levels of serum NLRP3 mRNA, miR-155-5p and miR-98-5p were observed and compared between the two groups, the patients with different illness condition, and the patients with different treatment outcomes. Receiver operating characteristic (ROC) curves were drawn to analyze the values of joint and single detection of serum NLRP3 mRNA, miR-155-5p and miR-98-5p in prediction of prognosis of the ARDS patients complicated with pulmonary infection.
    RESULTS The expression levels of serum NLRP3 mRNA and miR-155-5p of the infection group were higher than those of the no infection group, while the expression level of serum miR-98-5p of the infection group was lower than that of the no infection group(P < 0.05). The expression levels of serum NLRP3 mRNA and miR-155-5p showed upward trends in the mild group, the moderate group and the severe group, while the expression level of serum miR-98-5p showed a downward trend(P < 0.05). The expression levels of serum NLRP3 mRNA and miR-155-5p of the poor prognosis group were higher than those of the favorable prognosis group, while the expression levels of serum miR-98-5p of the poor prognosis group was lower than that of the favorable prognosis group(P < 0.05).ROC curve analysis showed that the joint detection of serum NLRP3 mRNA, miR-155-5p and miR-98-5p had high value in prediction of pulmonary infection in the ARDS patients(P < 0.05), and the area under curve (AUC) was 0.899.
    CONCLUSIONS The severity of pulmonary infection and exacerbation of ARDS are closely associated with the expressions of serum NLRP3 mRNA, miR-155-5p and miR-98-5p. The joint detection of the above indexes has high value in prediction of prognosis of the ARDS patients complicated with pulmonary infection.

     

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