[1]郭大伟,李 维,赵雪林.慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者血清miR-221-3p 和miR-149-3p 表达水平及其与预后的相关性分析[J].现代检验医学杂志,2023,38(04):72-77.[doi:10.3969/j.issn.1671-7414.2023.04.013]
　GUO Dawei,LI Wei,ZHAO Xuelin.Expression Levels of Serum miR-221-3p and miR-149-3p in Patients with Chronic Obstructive Pulmonary Disease Complicated by Type II Respiratory Failure and Their Correlation with Prognosis[J].Journal of Modern Laboratory Medicine,2023,38(04):72-77.[doi:10.3969/j.issn.1671-7414.2023.04.013]
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慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者血清miR-221-3p 和miR-149-3p 表达水平及其与预后的相关性分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年04期
页码:
72-77
栏目:
论著
出版日期:
2023-07-15

文章信息/Info

Title:
Expression Levels of Serum miR-221-3p and miR-149-3p in Patients with Chronic Obstructive Pulmonary Disease Complicated by Type II Respiratory Failure and Their Correlation with Prognosis
文章编号:
1671-7414（2023）04-072-06
作者:
郭大伟1; 李 维1; 赵雪林2
（1. 江油市人民医院，四川绵阳 621700；2. 广元市精神卫生中心，四川广元 628000）
Author(s):
GUO Dawei1;  LI Wei1;  ZHAO Xuelin2
（1. Jiangyou People’s Hospital, Sichuan Mianyang 621700，China； 2. Guangyuan Mental Health Center，Sichuan Guangyuan 628000，China）
关键词:
慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭; 微小核糖核酸-221-3p; 微小核糖核酸-149-3p
分类号:
R563.8；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.04.013
文献标志码:
A
摘要:
目的　分析慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者血清微小核糖核酸（micro RNA，miR）-221-3p 和miR-149-3p 水平变化及其与预后的相关性。方法　选取2019 年4 月～ 2021 年10 月在江油市人民医院治疗的180 例慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者作为研究对象，根据一年后随访结果分为生存组（n=120）和死亡组（n=60）。采用实时荧光定量PCR（qRT-PCR）法检测患者血清中miR-221-3p 和miR-149-3p 的相对表达水平，并对生存组、死亡组患者血清miR-221-3p 和miR-149-3p 水平进行比较。Spearman 法分析miR-221-3p，miR-149-3p 与急性生理和慢性健康评分Ⅱ（APACHE Ⅱ）的相关性。对影响慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者预后的因素进行Logistic 回归分析；受试者工作特征（ROC）曲线分析miR-221-3p 和miR-149-3p 的表达对慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者预后的预测价值。结果　生存组血清miR-221-3p，miR-149-3p 表达水平和APACHE Ⅱ评分分别为1.02±0.18，1.01±0.21 和12.80±4.45 分；死亡组慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者血清miR-221-3p，miR-149-3p 表达水平和APACHEⅡ评分分别为1.54±0.36，0.66±0.16 和27.45±6.05 分；与生存组相比，死亡组患者血清miR-221-3p 表达水平、APACHE Ⅱ评分均明显升高（t=12.938，18.395，P<0.01），miR-149-3p 表达水平显著降低（t=11.360，P<0.01），差异均有统计学意义；慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者血清miR-221-3p 水平与APACHE Ⅱ评分呈正相关（r=0.509，P<0.05），miR-149-3p 水平与APACHE Ⅱ评分呈负相关（r=-0.470，P<0.05）；Logistic 回归分析发现吸烟（OR=3.216，95%CI：1.112 ～ 9.304）、高APACHE Ⅱ评分（OR=1.355，95%CI：1.054 ～ 1.741）、高血清miR-221-3p 水平（OR=4.264，95%CI ：1.772 ～ 10.260）是影响慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者预后的危险因素（P<0.05），高血清miR-149-3p 水平（OR=0.198，95%CI：0.078 ～ 0.503）是影响患者预后的保护因素（P<0.01）；经ROC 曲线分析，血清miR-221-3p，miR-149-3p 及二者联合预测慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者预后的曲线下面积（AUC）分别为0.889，0.860 和0.959，二者联合检测优于其各自单独预测（Z =2.174，3.225，P=0.015，<0.01）。结论　慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者血清miR-221-3p 水平升高，miR-149-3p 水平降低，与患者预后有关，能够预测慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者的预后。
Abstract:
Objective　To analyse the changes in serum micro ribonucleic acid（miR）-221-3p and micro ribonucleic acid （miR）-149-3p levels in patients with chronic obstructive pulmonary disease(COPD) complicated by type II respiratory failure and their correlation with prognosis. Methods　A total of 180 patients with COPD complicated by type II respiratory failure who were treated in Jiangyou People’s Hospital from April 2019 to October 2021 were selected as the study subjects. The patients were divided into survival group（n=120）and death group（n=60）according to the follow-up results after one year. The relative expression levels of miR-221-3p and miR-149-3p in serum of patients were detected by real-time fluorescent quantitative PCR (qRT-PCR), and compared between patients in survival group and death group. Spearman method was used to analyze the correlation between miR-221-3p，miR-149-3p and Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score. Logistic regression analysis was used to analyze the factors affecting the prognosis of patients with COPD and type II respiratory failure, and the predictive value of the expression of miR-221-3p and miR-149-3p on the prognosis of patients with COPD and type II respiratory failure was analyzed by ROC curve. Results　The expression level of serum miR- 221-3p, miR-149-3p and APACHE Ⅱ score in survival group were 1.02±0.18, 1.01±0.21and 12.80±4.45, respectively.The expression level of serum miR-221-3p, miR-149-3p and APACHE Ⅱ score in the death group were 1.54±0.36，0.66±0.16 and 27.45±6.05, respectively. Compared with the survival group, the expression level of serum miR-221-3p and APACHE Ⅱ score in the death group were greatly higher (t=12.938, 18.395, P<0.01), the expression level of miR-149-3p was greatly lower (t=11.360, P<0.01). There was a positive correlation between the serum miR-221-3p level and APACHE Ⅱ score in patients with COPD complicated by type II respiratory failure (r=0.509, P<0.05), the level of miR-149-3p was negatively correlated with APACHE Ⅱ score (r=-0.470, P<0.05). Logistic regression analysis showed that smoking (OR=3.216, 95%CI：1.112 ～ 9.304), high APACHE Ⅱ score (OR=1.355, 95%CI：1.054 ～ 1.741) and high serum miR-221-3p level (OR=4.264, 95%CI： 1.772 ～ 10.260) were risk factors affecting the prognosis of COPD complicated by type II respiratory failure (P<0.05), and high serum miR-149-3p level (OR=0.198，95%CI：0.078 ～ 0.503) was a protective factor affecting the prognosis (P<0.01). The area under the curve (AUC) of serum miR-221-3p, miR-149-3p and both of them to predict the prognosis of patients with COPD combined with type II respiratory failure were 0.889, 0.860 and 0.959, respectively, and their combination was better than individual predictions (Z=2.174, 3.225, P=0.015, <0.01). Conclusion　The level of serum miR-221-3p in patients with COPD and type II respiratory failure was elevated, the level of miR-149-3p was decreased, and they were related to the prognosis of patients, and can predict the prognosis of patients with COPD complicated by type II respiratory failure.

参考文献/References:

[1] CELLI B R, WEDZICHA J A. Update on clinical aspects of chronic obstructive pulmonary disease[J]. New England Journal of Medicine, 2019, 381(13):1257-1266.
[2] 崔雨佳, 刘忠．外周血嗜酸性粒细胞水平与慢性阻塞性肺疾病急性加重期患者临床预后的相关性分析[J]．现代检验医学杂志, 2020, 35(3): 129-132, 164. CUI Yujia, LIU Zhong. Relationship between peripheral blood eosinophil level and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Journal of Modern Laboratory Medicine, 2020, 35(3): 129-132, 164.
[3] YILDIZ F. The efficacy of lung volume reduction coil treatment in patients with severe chronic obstructive pulmonary disease(COPD) type II respiratory failure[J]. International Journal of Chronic Obstructive Pulmonary Disease, 2020, 15: 479-486.
[4] YANG Yang, WANG Yujiao, WANG Fang, et al. The roles of miRNA, lncRNA and circRNA in the development of osteoporosis[J]. Biological Research, 2020, 53(1): 40.
[5] LI Xinzhi, BALLANTYNE L L, YU Ying, et al. Perivascular adipose tissue-derived extracellular vesicle miR-221-3p mediates vascular remodeling[J]. The FASEB Journal, 2019, 33(11): 12704-12722.
[6] ZHOU Chenfei, MA Jing, HUANG Lei, et al. Cervical squamous cell carcinoma-secreted exosomal miR-221-3p promotes lymphangiogenesis and lymphatic metastasis by targeting VASH1[J]. Oncogene, 2019, 38(8): 1256-1268.
[7] CAO Yingying, WANG Zhenhua, YAN Yuqing, et al. Enterotoxigenic bacteroidesfragilis promotes intestinal inflammation and malignancy by inhibiting Exosome-Packaged miR-149-3p[J]. Gastroenterology, 2021, 161(5): 1552-1566, e12.
[8] XU Lina, GAO Haipeng, WANG Weizhen. Joint detection of miR-149-3p and hepcidin predicts the onset of obstructive sleep apnea syndrome in obese patients[J]. Laryngoscope Investigative Otolaryngology, 2022, 7(5): 1643-1651.
[9] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组,中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会. 慢性阻塞性肺疾病诊治指南（2021 年修订版）[J]. 中华结核和呼吸杂志, 2021, 44(3): 170-205. Chronic Obstructive Pulmonary Disease Group of Chinese Thoracic Society, Chronic Obstructive Pulmonary Disease Committee of Chinese Association of Chest Physician. Guidelines for the diagnosis and management of chronic obstructive pulmonary disease (revised version 2021) [J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2021, 44(3):170-205.
[10] 阎锡新．呼吸衰竭[M]． 2 版．北京：人民卫生出版社,2016：112-145． YAN Xixin. Respiratory failure[M].2th Ed. Beijing： People’s Medical Publishing House, 2016: 112-145．
[11] 李若倩, 刘云, 李若然．外周血红细胞分布宽度和超敏C- 反应蛋白水平检测在慢性阻塞性肺疾病诊断中的价值分析[J]．现代检验医学杂志, 2020,35(3): 123-125, 137. LI Ruoqian, LIU Yun, LI Ruoran. Value of detecting peripheral blood red blood cell distribution width and high sensitivity C reactive protein in the diagnosis of chromic obstructive pulmonary disease[J]. Journal of Modern Laboratory Medicine, 2020, 35(3): 123-125, 137.
[12] AGUST? A. HOGG J C. Update on the pathogenesis of chronic obstructive pulmonary disease[J]. New England Journal of Medicine, 2019, 381(13): 1248-1256.
[13] 陈志勇, 罗世林, 张健, 等. 慢阻肺患者血清IL-17,IL-27 和IL-33 水平表达及与不同临床分期FeNO和肺功能的相关性研究[J]. 现代检验医学杂志,2021, 36(4): 152-155, 166. CHEN Zhiyong, LUO Shilin, ZHANG Jian, et al. Expression of serum IL-17, IL-27 and IL-33 in patients with chronic obstructive pulmonary disease and its correlation with FeNO and lung function in different clinical stages[J]. Journal of Modern Laboratory Medicine, 2021, 36(4): 152-155, 166.
[14] 龙借帆, 李翠, 高元标, 等．联合检测血清SIRT1 和CTRP5 水平对慢性阻塞性肺疾病急性加重期患者预后的预测价值研究[J]. 现代检验医学杂志, 2022,37(3): 162-166, 176. LONG Jiefan, LI Cui, GAO Yuanbiao, et al. Prognostic value of combined detection of serum SIRT1 and CTRP5 levels in patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Journal of Modern Laboratory Medicine, 2022, 37(3): 162-166, 176.
[15] 胡小燕, 郑晓, 嵇华夏, 等．血清PCT 与BNP 水平联合检测对慢性阻塞性肺疾病急性加重期并发心力衰竭的临床诊断价值[J]. 现代检验医学杂志, 2021,36(3): 128-131, 136. HU Xiaoyan, ZHENG Xiao, JI Huaxia, et al. Clinical diagnostic value of combined detection of serum PCT and BNP levels in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with heart failure[J]. Journal of Modern Laboratory Medicine, 2021, 36(3): 128-131, 136.
[16] CHEN Qihua, DENG Na, LU Ke, et al. Elevated plasma miR-133b and miR-221-3p as biomarkers for early Parkinson’s disease[J]. Scientific Reports, 2021, 11(1): 15268.
[17] CA?AS J A, RODRIGO-MU?OZ J M, SASTRE B, et al. MicroRNAs as potential regulators of immune response networks in asthma and chronic obstructive pulmonary disease[J]. Frontiers in Immunology, 2021, 11(1): 608666-608675.
[18] 宫柏琪, 张琳, 王娜, 等.AMI 患者血浆miR-221-3p,miR-208b-3p 表达水平与心肌损伤标志物及左心功能的关系[J]. 河北医药, 2021, 43(14): 2106-2109. GONG Baiqi, ZHANG Lin, WANG Na, et al. Correlation between the expression level of miR2213p, miR208b-3p and the markers of myocardial injury as well as left ventricular function in patients with acute myocardial infarction[J]. Hebei Medical Journal, 2021, 43(14): 2106-2109.
[19] SHEN Yahui, LU Huiyu, SONG Guixian. MiR-221-3p and miR-92a-3p enhances smoking-induced inflammation in COPD [J]. Journal of Clinical Laboratory Analysis, 2021, 35(7): e23857.
[20] ZHANG Xiuli, WANG Yaping, HE Xiang, et al. Diagnosis of chronic obstructive pulmonary disease and regulatory mechanism of miR-149-3p on alveolar inflammatory factors and expression of surfactant proteins a(SP-A)and D(SP-D)on lung surface mediated by Wnt pathway[J]. Computational Intelligence and Neuroscience, 2022(1): 7205016.
[21] LEI Zhenwu, GUO Hui, ZOU Shenchun, et al. Long noncoding RNA maternally expressed gene regulates cigarette smoke extract induced lung inflammation and human bronchial epithelial apoptosis via miR1493p[J]. Experimental and Therapeutic Medicine, 2021, 21(1): 60-70.
[22] 刘建军．改良DECAF 评分、DECAF 评分、CAPS评分及APACHE Ⅱ评分对慢性阻塞性肺疾病急性加重合并呼吸衰竭患者预后的预测价值对比分析[J].系统医学, 2019, 4(19): 13-16. LIU Jianjun. Comparative analysis of predictive value of modified DECAF score, DECAF score, CAPS score and APACHE II score in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure [J]. Systems Medicine, 2019, 4(19): 13-16.

备注/Memo

备注/Memo:
基金项目： 广元市科学技术局项目（编号：广科发 [2019]60 号-69）：BIPAP 无创呼吸机联合心理干预治疗慢性阻塞性肺病合并II 型呼吸衰竭的临床疗效研究。
作者简介：郭大伟（1984-），男，本科，主治医师，研究方向：呼吸病学，E-mail：mnu2z6@sina.com。
更新日期/Last Update: 2023-07-15