血清微小RNA-499a-5p、成纤维细胞生长因子9、炎性因子与脓毒症所致急性肺损伤患者病情严重程度和预后的关系

马静; 郑喜胜; 李长力; 赵聪源; 董照刚

doi:10.7619/jcmp.20233049

血清微小RNA-499a-5p、成纤维细胞生长因子9、炎性因子与脓毒症所致急性肺损伤患者病情严重程度和预后的关系

Correlations of serum microRNA-499A-5P, fibroblast growth factor 9 and inflammatory factor with the severity and prognosis of acute lung injury caused by sepsis

摘要

摘要:
目的探讨血清微小RNA-499a-5p(miR-499a-5p)、成纤维细胞生长因子9(FGF9)、炎性因子与脓毒症所致急性肺损伤(ALI)患者病情严重程度和预后的关系。
方法选取接受诊治的151例脓毒症患者为研究对象，根据ALI的发生情况分为脓毒症并发ALI组(68例)和一般脓毒症组(83例)。根据氧合指数，将脓毒症并发ALI患者分为轻症组(23例)、中症组(26例)和重症组(19例)。以脓毒症并发ALI患者诊治28 d内的生存情况，分为预后良好组(43例)和预后不良组(25例)。另外，选取同期体检健康者151例为健康组。分析各组miR-499a-5p、FGF9及炎症因子间的差异和相关性。采用受试者工作特征(ROC)曲线分析血清miR-499a-5p、FGF9对脓毒症患者并发ALI的预测效能。
结果轻症组、中症组、重症组患者的miR-499a-5p和FGF9水平表现为依次降低，而炎症因子白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平依次升高，差异有统计学意义(P < 0.05)。预后不良组的miR-499a-5p、FGF9低于预后良好组, IL-1、IL-6、TNF-α、CRP水平高于预后良好组，差异有统计学意义(P < 0.05)。脓毒症并发ALI患者的miR-499a-5p、FGF9与IL-1、IL-6、TNF-α、CRP呈负相关(P < 0.05); miR-499a-5p可正向调节FGF9表达(P < 0.05)。miR-93、miR-135a联合预测脓毒症并发ALI患者预后的诊断效能高于单独预测，差异有统计学意义(P < 0.05)。
结论 miR-499a-5p、FGF9、炎性因子水平与脓毒症所致ALI患者的病情程度和预后相关。miR-499a-5p和FGF9可能作为潜在的生物标志物用于脓毒症并发ALI的预后评估。

Abstract:
Objective To explore the correlation of serum microRNA-499a-5p (miR-499a-5p), fibroblast growth factor 9 (FGF9) and inflammatory factors with the severity and prognosis of acute lung injury (ALI) caused by sepsis.
Methods A total of 151 septic patients were selected for the study. They were divided into sepsis with acute lung injury (ALI) group (68 cases) and general sepsis group (83 cases) based on the occurrence of ALI. According to the oxygenation index, septic patients with ALI were further categorized into mild (23 cases), moderate (26 cases), and severe (19 cases) groups. The survival status of septic patients with ALI was assessed within 28 days, and they were divided into good prognosis group (43 cases) and poor prognosis group (25 cases). Additionally, 151 healthy individuals undergoing physical examinations during the same period were selected as the control group. The differences and correlations among miR-499a-5p, FGF9 and inflammatory factors in each group were analyzed. The predictive efficacy of serum miR-499a-5p and FGF9 in patients with sepsis complicated with ALI was analyzed by receiver operating characteristic (ROC) curve.
Results The levels of miR-499a-5p and FGF9 in the mild, moderate, and severe groups showed significant decrease in a sequential manner, while the inflammatory factors interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) levels showed significant increase in a sequential manner (P < 0.05). The miR-499a-5p and FGF9 levels in the poor prognosis group were significantly lower than those in the good prognosis group, while the IL-1, IL-6, TNF-α, and CRP levels were significantly higher in the poor prognosis group (P < 0.05). In patients with sepsis and ALI, miR-499a-5p and FGF9 were negatively correlated with IL-1, IL-6, TNF-α, and CRP levels (P < 0.05); miR-499a-5p could positively regulate FGF9 expression (P < 0.05). The diagnostic efficacy of predicting the prognosis of septic patients with ALI using a combination of miR-93 and miR-135a was significantly higher than that of individual prediction (P < 0.05).
Conclusion The levels of miR-499a-5p, FGF9 and inflammatory factors are associated with the severity and prognosis of ALI in patients with sepsis. The miR-499a-5p and FGF9 may serve as potential biomarkers for the evaluation of prognosis in septic patients with ALI.

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