| 甘平,蓝军.重症肺炎 64例外周血微 RNA-34a、沉默信息调节因子 1的表达[J].安徽医药,2024,28(1):180-184. |
| 重症肺炎 64例外周血微 RNA-34a、沉默信息调节因子 1的表达 |
| Expression of peripheral blood microRNA in and silencing information regulator 1 in 64 cases of severe pneumonia |
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| DOI：10.3969/j.issn.1009-6469.2024.01.038 |
| 中文关键词: 肺炎 微 RNA-34a 沉默信息调节因子 1 肿瘤坏死因子 α 细胞黏附分子 白细胞介素 6 高迁移率族蛋水平，白质类 预后 |
| 英文关键词: Pneumonia miR-34a Silencing information regulator 1 Tumor necrosis factor-alpha Cell adhesion molecules Interleukin-6 High mobility group proteins Prognosis |
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| 中文摘要: |
| 目的研究重症肺炎病人外周血微 RNA-34a(miR-34a)、沉默信息调节因子 1(Sirt1)的表达变化及临床意义。方法选取 2017年 10月至 2020年 4月武警重庆总队医院收治的 64例重症肺炎病人为重症肺炎组，同期收治的 80例普通肺炎病人为普通肺炎组，进行健康体检的 70例健康志愿者为对照组。采用实时荧光定量 PCR法( qRT-PCR)检测外周血 miR-34a表达水平，采用酶联免疫吸附法检测血清 Sirt1、炎症细胞因子表达水平； Kaplan-Meier生存分析研究 miR-34a与 Sirt1表达水平与重症肺炎组病人预后的关系； Cox回归分析影响重症肺炎病人预后的因素。结果重症肺炎组 miR-34a的表达水平高于普通肺炎组和对照组( 1.65±0.28比 1.32±0.33、1.00±0.25)Sirt1表达水平低于普通肺炎组和对照组［( 6.83±1.59)μg/L比( 8.94±1.62)μg/L、(12.11±1.77)μg/L］(P<0.05)； miR-34a表达与 Sirt1表达水平存在明显负相关( P<0.05)。高危、中危病人 miR-34a表达水平高于低危病人， Sirt1表达水平低于低危病人( P<0.05)，高危病人 miR-34a表达水平高于中危病人， Sirt1表达水平低于中危病人(P<0.05)。 miR-34a高表达病人血清肿瘤坏死因子 -α(TNF-α)、细胞间黏附分子 -1(ICAM-1)、白细胞介素( IL)-6和高迁移率族蛋白 B-1(HMGB1)水平高于 miR-34a低表达病人， 30 d累积生存率低于 miR-34a低表达病人( P<0.05)； Sirt1高表达病人血清 TNF-α、ICAM-1、IL-6、HMGB1水平低于 Sirt1低表达病人， 30 d累积生存率高于 Sirt1低表达病人( P<0.05)。ICAM-1、miR-34a及 Sirt1均是影响重症肺炎病人预后的独立危险因素( P<0.05)。结论重症肺炎病人外周血中 miR-34a表达增加与血清 Sirt1表达降低具有相关性，且 miR-34a、Sirt1的变化与病情加重、炎症反应激活、预后不良有关。 |
| 英文摘要: |
| Objective To study the expression and clinical significance of peripheral blood microRNA (miR-34a) and silencing infor- mation regulator 1 (Sirt1) in patients with severe pneumonia.Methods Sixty four patients with severe pneumonia admitted to Chongq-ing Municipal Corps Hospital of PAP from October 2017 to April 2020 were selected as the severe pneumonia group, and 80 patientswith common pneumonia admitted during the same period were selected as the common pneumonia group, and 70 healthy volunteerswho underwent health checkups were selected as the control group. The expression level of peripheral blood miR-34a was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The expression levels of serum Sirt1 and inflammatory cytokines were de- tected by enzyme-linked immunosorbent assay. Kaplan-Meier survival analysis was performed to study the relationship between the ex- pression levels of miR-34a and Sirt1 and the prognosis of patients with severe pneumonia. Cox regression analysis of factors was per-formed to analyze the factors affecting the prognosis of severe pneumonia patients.Results The expression level of miR-34a was high- er than that in the common pneumonia group and the control group (1.65±0.28 vs. 1.32±0.33, 1.00±0.25), and the expression level ofSirt1 was lower in the severe pneumonia group than in the common pneumonia group and the control group [(6.83±1.59)μg/L vs. (8.94± 1.62)μg/L, (12.11±1.77) μg/L], and the difference was statistically significant (P<0.05). There was a negative correlation between the expression level of miR-34a and the expression level of Sirt1 (P<0.05). The expression level of miR-34a was higher, and the expression level of Sirt1 was lower in high-risk and intermediate-risk patients than that in low-risk patients (P<0.05). The expression level of miR34a was higher, and the expression level of Sirt1 was lower in high-risk patients than that in intermediate-risk patients (P<0.05). Serum tumor necrosis factor-α (TNF-α), intercellular adhesion molecule-1 (ICAM-1), interleukin-6 (IL-6) and high mobility group box B-1 (HMGB1) levels in patients with high expression of miR-34a were higher than those in patients with low expression of miR-34a, and the 30-day cumulative survival rate was lower than that of patients with low expression of miR-34a (P<0.05). Serum TNF-α, ICAM-1, IL-6 and HMGB1 levels in patients with high expression of Sirt1 were lower than those in patients with low expression of Sirt1, and the 30day cumulative survival rate was higher than that of patients with low expression of Sirt1 (P<0.05). ICAM-1, miR-34a and Sirt1 were in- dependent risk factors affecting the prognosis of patients with severe pneumonia (P<0.05).Conclusions The increased expression of peripheral blood miR-34a is related to the decreased expression of serum Sirt1 in patients with severe pneumonia. The changes in miR34a and Sirt1 are related to aggravation of the disease, activation of inflammatory response and poor prognosis. |
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