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目的探讨脓毒症患者外周血白细胞中微小RNA-143(microRNA-143,miR-143)的表达变化及其与脓毒症严重程度的关系。方法采用实时定量PCR法检测40例脓毒症患者、20例非感染全身性炎症反应综合征患者和20例正常对照者外周血白细胞中miR-143表达量。并测定血清肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)和白介素-10(interleukin-10,IL-10)水平,分析miR-143与白细胞总数、TNF-α,IL-10和序贯器官衰竭估计评分间相关性。结果脓毒症组miR-143表达量较正常对照组明显降低(P<0.01),白细胞、IL-10水平和IL-10/TNF-α比值明显升高(P<0.01),与非感染全身性炎症反应综合征组间比较差异无统计学意义(P>0.05);脓毒症组中死亡组miR-143表达量较存活组明显降低(P<0.05),而IL-10水平和IL-10/TNF-α比值升高(P<0.01);脓毒症患者miR-143表达量与序贯器官衰竭估计评分、血清TNF-α和IL-10呈明显负相关;与白细胞无相关性。结论脓毒症患者外周血miR-143水平可反映机体免疫反应状态,在判断疾病严重程度及预后中有一定价值。
Objective To investigate the expression of microRNA-143 (miR-143) in peripheral blood leukocytes of patients with sepsis and its relationship with the severity of sepsis. Methods Real-time quantitative PCR was used to detect miR-143 expression in peripheral blood leukocytes from 40 sepsis patients, 20 non-infected patients with systemic inflammatory response syndrome and 20 normal controls. Serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) were measured and the levels of miR-143 and total leukocytes, TNF- Correlation between scores of sequential organ failure assessment. Results The expression of miR-143 in sepsis group was significantly lower than that in normal control group (P <0.01), while the ratio of leukocyte, IL-10 and IL-10 / TNF- (P> 0.05). The expression of miR-143 in the death group was significantly lower than that in the survivor group (P <0.05), while the level of IL-10 and IL- (P <0.01). The expression of miR-143 in patients with sepsis was negatively correlated with the estimated score of sequential organ failure, serum TNF-α and IL-10, but not with leukocytes. Conclusion The level of miR-143 in peripheral blood of patients with sepsis can reflect the status of immune response, which is of value in judging the severity and prognosis of the disease.