| 李媛媛,刘娇,郭娜.血清长链非编码 RNA癌易感性候选基因 2表达水平对脓毒症并发急性肾损伤病儿预后的预测价值[J].安徽医药,2023,27(6):1235-1239. |
| 血清长链非编码 RNA癌易感性候选基因 2表达水平对脓毒症并发急性肾损伤病儿预后的预测价值 |
| Predictive value of serum long chain non-coding RNA cancer susceptibility candidate gene 2 expression level in the prognosis of children with sepsis complicated with acute kidney injury |
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| DOI：10.3969/j.issn.1009-6469.2023.06.041 |
| 中文关键词: 脓毒症 急性肾损伤 肌酸酐 长链非编码 RNA 癌易感性候选基因 2 预后 儿童 |
| 英文关键词: Sepsis Acute kidney injury Creatinine Long non-coding RNA Cancer susceptibility candidate 2 Prognosis Child |
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| 中文摘要: |
| 目的探究血清长链非编码 RNA(lncRNA)癌易感性候选基因 2(CASC2)表达水平对脓毒症并发急性肾损伤( AKI)病儿预后的预测价值。方法以 2019年 2月至 2021年 2月中国人民解放军总医院第八医学中心收治的 83例脓毒症并发 AKI的病儿为研究对象，根据其 28 d生存情况分为生存组 57例，死亡组 26例。收集病儿的一般临床资料，包括尿量、动脉血二氧化碳分压( PaCO2)、急性生理和慢性健康系统 Ⅱ(APACHE Ⅱ)评分、胱抑素 C(CysC)、 C反应蛋白( CRP)、降钙素原、血肌酐等指标水平，并比较。利用实时荧光定量 PCR(qRT-PCR)法检测血清 lncRNA CASC2水平。采用多因素 logistic回归分析影响脓毒症并发 AKI病儿预后的危险因素。受试者操作特征( ROC)曲线分析血清 lncRNA CASC2、血肌酐对脓毒症并发 AKI病儿死亡的预测价值。并利用 Pearson相关性分析血清 lncRNA CASC2与临床资料的关系。结果病儿一般临床资料来看，生存组尿量为(0.98±0.21)mL·kg-1·h-1PaCO2为( 45.38±4.37)mmHg、APACHE Ⅱ评分为( 17.38±4.09)分、 CysC为( 17.38±4.09)mg/L、CRP为(43.61±5.19)mg/L、原为( 29.34±3.15)μg/L、血肌酐为( 258.19±32.71)μmol/L，死亡组尿量为( 0.86±0.18)mL·kg-1 ·h-1、PaCO2为(38.41±4.11)mmHg、APACHE Ⅱ评分为(23.26±4.87)分、 CysC为(2.23±0.37)mg/L、CRP为( 46.28±5.28)mg/L、降钙素原为降钙素、(38.46±4.21)μg/L、血肌酐为( 328.34±44.52)μmol/L，组间比较，差异有统计学意义( P<0.05)。与生存组相比，死亡组血清 lncRNA CASC2水平显著降低( P<0.05)。多因素 logistic回归分析显示， lncRNA CASC2低表达、血肌酐高水平是影响脓毒症并发 AKI病儿预后的危险因素( P<0.05)。 ROC曲线分析显示，血清 lncRNA CASC2、血肌酐联合预测脓毒症并发 AKI病儿死亡的灵敏度为 96.2%，特异度为 78.9%，曲线下面积( AUC)值显著高于其单一指标检测( Z=2.25，P=0.024；Z=2.05，P=0.040)。 Pearson相关性分析结果显示，血清 lncRNA CASC2与病儿尿量、 PaCO2呈正相关( P<0.05)，与 APACHE Ⅱ评分、 CysC、CRP、降钙素原、血肌酐呈显著负相关( P<0.05)。结论脓毒症并发 AKI预后不良病儿血清 lncRNA CASC2水平较预后良好病儿显著下调，其是影响脓毒症并发 AKI病儿预后的危险因素， lncRNA CASC2联合血肌酐对脓毒症并发 AKI病儿的预后有一定的预测价值。 |
| 英文摘要: |
| Objective To explore the predictive value of serum long non-coding RNA (lncRNA) cancer susceptibility candidategene 2 (CASC2) expression level in children with sepsis complicated with acute kidney injury (AKI).Methods With 83 cases of patients with sepsis and AKI admitted to the Eighth Medical Center of the General Hospital of the PLA from February 2019 to February2021. According to their 28-day survival, they were grouped into a survival group of 57 cases and a death group of 26 cases. Generalclinical data of children, including urine volume, arterial partial pressure of carbon dioxide (PaCO2), acute physiology and chronichealth system Ⅱ (APACHE Ⅱ) scores, cystatin C (CysC), C-reactive protein (CRP), procalcitonin, and serum creatinine, were collected and compared. Real-time quantitative PCR (qRT-PCR) was performed to measure the serum lncRNA CASC2 level in children. Multivariate Logistic regression was used to analyze the risk factors affecting the prognosis of children with sepsis complicated with AKI.ROC curve was performed to analyze the predictive value of serum lncRNA CASC2 and serum creatinine on the death of children withsepsis complicated with AKI. Pearson correlation was used to analyze the relationship between serum lncRNA CASC2 and general clinical data.Results According to the general clinical data of children in the survival group, the urine volume was (0.98±0.21) mL·kg-1 · h-1, PaCO2 was (45.38±4.37) mmHg, APACHE Ⅱ score was (17.38±4.09) points, CysC was (17.38±4.09) mg/L, CRP was (43.61±5.19)mg/L, and procalcitonin was (29.34±3.15) μg/L, serum creatinine (258.19±32.71)μmol/L, while in the death group, the urine volumewas (0.86±0.18) mL·kg-1·h-1, PaCO2 was (38.41±4.11) mmHg, APACHE Ⅱ score was (23.26±4.87) points, CysC was (2.23±0.37) mg/L, CRP was (46.28±5.28) mg/L, and procalcitonin was (38.46±4.21)μg/L, serum creatinine (328.34±44.52)μmol/L, the differences between the two groups were statistically significant (P<0.05). Multivariate Logistic regression analysis showed that low expression of lncRNA CASC2 and high level of serum creatinine were risk factors affecting the prognosis of children with sepsis complicated with AKI(P<0.05). ROC curve analysis showed that the combination of serum lncRNA CASC2 and serum creatinine had a sensitivity of 96.2 %and a specificity of 78.9 % to predict the death of children with sepsis complicated with AKI, and the area enclosed by the coordinateaxis under the ROC curve (AUC) was obviously higher than that of its single index detection (Z=2.25, P=0.024; Z=2.05, P=0.040). Theresults of Pearson correlation analysis showed that serum lncRNA CASC2 was positively correlated with urine volume and arterial carbon dioxide partial pressure (P<0.05), and was negatively correlated with APACHE Ⅱ score, cystatin C, C-reactive protein, procalcitonin and serum creatinine, the differences between the two groups were statistically significant (P<0.05).Conclusions The level of serum lncRNA CASC2 in children with sepsis complicated with AKI with poor prognosis is obviously lower than that of children withgood prognosis. It is a risk factor affecting the prognosis of children with sepsis complicated with AKI. LncRNA CASC2 combined withserum creatinine had a certain predictive value for the prognosis of children with sepsis complicated with AKI. |
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