[1]祝勇军,邓小军.急性脓毒性休克患者血清sCD73和miR-124a表达水平及与28天预后的预测价值研究[J].现代检验医学杂志,2025,40(01):94-98.[doi:10.3969/j.issn.1671-7414.2025.01.018]
　ZHU Yongjun,DENG Xiaojun.Study on the Expression Levels of Serum sCD73 and miR-124a in Patients with Acute Septic Shock and Their Predictive Value for 28-day Prognosis[J].Journal of Modern Laboratory Medicine,2025,40(01):94-98.[doi:10.3969/j.issn.1671-7414.2025.01.018]
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急性脓毒性休克患者血清sCD73和miR-124a表达水平及与28天预后的预测价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年01期
页码:
94-98
栏目:
论著
出版日期:
2025-01-15

文章信息/Info

Title:
Study on the Expression Levels of Serum sCD73 and miR-124a in Patients with Acute Septic Shock and Their Predictive Value for 28-day Prognosis
文章编号:
1671-7414（2025）01-094-05
作者:
祝勇军; 邓小军
（成都市第三人民医院急诊科，成都 610000）
Author(s):
ZHU Yongjun; DENG Xiaojun
（Department of Emergency，Chengdu Third People’s Hospital, Chengdu 610000, China）
关键词:
急性脓毒性休克; 可溶性CD73; 微小RNA-124a
分类号:
R631.4；R392.11
DOI:
10.3969/j.issn.1671-7414.2025.01.018
文献标志码:
A
摘要:
目的 研究急性脓毒性休克患者血清可溶性CD73（sCD73）和微小RNA（miR）-124a 表达水平及其28 天预后预测价值。方法 前瞻性分析2021 年6 月～ 2023 年12 月成都市第三人民医院109 例急性脓毒性休克患者，根据28 天预后分为生存组（n=87）与死亡组（n=22），比较两组临床资料、血清sCD73 和miR-124a 水平；Pearson 相关性分析sCD73，miR-124a 与急性生理与慢性健康评价系统Ⅱ（APACHE Ⅱ）、序贯器官衰竭估计（SOFA）评分、C 反应蛋白（CRP）、降钙素原（PCT）的关系；受试者工作特征（ROC）曲线分析sCD73 与miR-124a 对预后的预测价值，采用交互作用系数γ 分析sCD73 与miR-124a 在急性脓毒性休克患者预后中的交互作用。结果 死亡组年龄、APACHE Ⅱ，SOFA 评分、CRP，PCT 水平均高于生存组（t=4.485 ～ 14.147），机械通气时间长于生存组（t=7.215），差异具有统计学意义（均P ＜ 0.001）；死亡组血清sCD73（3.69±1.12μg/L）水平低于生存组（6.42±2.38μg/L），miR-124a（3.31±0.70）表达高于生存组（2.63±0.52），差异具有统计学意义（t=5.222，5.089，均P ＜ 0.001）。Pearson 相关性分析显示，血清sCD73 与APACHEⅡ，SOFA评分、CRP，PCT呈负相关（r=-0.712 ～ -0.649，均P＜ 0.001）；miR-124a 与APACHE Ⅱ，SOFA 评分、CRP，PCT 呈正相关（r=0.643 ～ 0.728，均P ＜ 0.001）。血清sCD73，miR-124a 与急性脓毒性休克患者28 天治疗预后显著相关（偏相关系数= -0.882，0.896，均P ＜ 0.001）；血清sCD73，miR-124a 预测28 天治疗预后的AUC(95%CI) 分别为0.765（0.674 ～ 0.841），0.754（0.662 ～ 0.831），联合预测28天治疗预后的AUC(95%CI) 为0.916（95%CI：0.847 ～ 0.960），大于单项指标，差异具有统计学意义（Z=4.352，4.221，均P ＜ 0.001）。sCD73 低表达与miR-124a 高表达在急性脓毒性休克患者28 天死亡风险中呈正向交互作用（OR=6.668，95%CI：1.245 ～ 35.714，γ=1.133，P ＜ 0.024）。结论 sCD73 低表达与miR-124a 高表达在急性脓毒性休克患者28天死亡风险中呈正向交互作用，联合检测对预后预测有一定参考价值。
Abstract:
Objective To investigate the relationship between soluble CD73(sCD73) and miRNA（miR）-124a expression level and the severity of acute septic shock and its predictive value for 28 days. Methods A prospective analysis was conducted on 109 patients with acute septic shock admitted to the Third People’s Hospital of Chengdu from June 2021 to December 2023. These patients were divided into a survival group (n=87) and a death group (n=22) based on their 28-day prognosis. The clinical data, serum sCD73, miR-124a levels of the two groups were compared, Pearson correlation analysis was used to analyze the relationship between sCD73, miR-124a and acute physiology and chronic health evaluation system II (APACHE Ⅱ ), sequential organ failure assessment (SOFA), C-reactive protein (CRP) and procalcitonin (PCT). The predictive value of sCD73 and miR- 124a for prognosis was analyzed using receiver operating characteristic (ROC) curve analysis, and the interaction between sCD73 and miR-124a in the prognosis of patients with acute septic shock was analyzed using the interaction coefficient γ. Results The age, APACHE II, SOFA score, CRP and PCT levels of the death group were higher than that of the survival group(t=4.485 ～ 14.147), and the duration of mechanical ventilation was longer than that of the survival group(t=7.215)， with statistically significant differences (all P<0.001)，respectively. Serum sCD73(3.69 ± 1.12 μg/L) levels were lower in the death group than in the survival group(6.42 ± 2.38 μg/L), and miR-124a (3.31±0.70) was higher than in the survival group(2.63 ±0.52)，and the differences were statistically significant (t=5.222, 5.089, all P<0.001). Serum sCD73 and APACHE II, SOFA score, CRP and PCT was negatively correlated (r =-0.712 ～ -0.649，all P<0.001)，miR-124a and APACHE II, SOFA score, CRP and PCT was positively correlated (r=0.643 ～ 0.728, all P<0.001). Serum sCD73, miR-124a was significantly correlated with the prognosis of patients with acute septic shock after 28 days of treatment (partial correlation coefficient -0.882, 0.896, all P<0.001). The AUC(95%CI) of serum sCD73 and miR-124a for predicting the prognosis of 28-day treatment were 0.765 (0.674 ～ 0.841) and 0.754 (0.662 ～ 0.831), respectively. The AUC(95%CI) of the combined prediction of 28-day treatment prognosis was 0.916 (0.847 ～ 0.960), which was greater than that of the single indicator, and the differences were statistically significant (Z=4.352, 4.221, all P<0.001). Low expression of sCD73 and high expression of miR-124a showed a positive interaction in the 28-day mortality risk of patients with acute septic shock (OR=6.668, 95%CI: 1.245 ～ 35.714, γ=1.133, P<0.024). Conclusion Low sCD73 expression and high miR-124a expression positively interacted with each other in the risk of death at 28-day in patients with acute septic shock, and the combined assay is informative for prognostic prediction.

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备注/Memo

备注/Memo:
基金项目：2020 年四川省医学（青年创新）科研课题项目：S20389。
作者简介：祝勇军（1983-），男，本科，主治医师，研究方向：急诊科，E-mail：U7far6bo@21cn.com。
更新日期/Last Update: 2025-01-15