Predictive value of serum microRNA-155-5p on prognosis in sepsis patients with acute liver injury / 中国医师进修杂志

ABSTRACT

Objective:To explore the predictive value of serum microRNA (miR)-155-5p on prognosis in sepsis patients with acute liver injury.Methods:The clinical data of 103 sepsis patients with acute liver injury from March 2017 to March 2019 in Rongjun Hospital, Zhejiang Province, were retrospectively analyzed. Among them, 57 patients were improved (survival group) and 46 patients died in hospital (death group). The clinical data and serum miR-155-5p were compared between 2 groups, and the influencing factors of prognosis in sepsis patients with acute liver injury were analyzed. The receiver operating characteristic (ROC) curve was used to evaluate the prognosis value of miR-155-5p.Results:The incidence of septic shock, age, procalcitonin (PCT), C-reactive protein (CRP), D-dimer, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure score (SOFA) and miR-155-5p in death group were significantly higher than those in survival group 95.65% (44/46) vs. 45.61% (26/57), (50.82 ± 10.52) years vs. (43.84 ± 7.32) years, (16.42 ± 4.97) μg/L vs. (7.20 ± 2.19) μg/L, (23.21 ± 8.59) mg/L vs. (16.73 ± 5.04) mg/L, (10.84 ± 3.17) mg/L vs. (4.16 ± 2.15) mg/L, (22.37 ± 3.16) scores vs. (16.72 ± 4.10) scores, (10.98 ± 3.74) scores vs. (6.84 ± 2.47) scores and 3.10 ± 0.97 vs. 2.25 ± 0.63, and there were statistical differences ( P<0.05). Multivariate Logistic regression analysis result showed that the APACHE Ⅱ, SOFA, PCT and miR-155-5p were the independent risk factors of prognosis in sepsis patients with acute liver injury ( OR=3.173, 2.732, 2.553 and 2.153; 95% CI 2.127 to 6.312, 2.018 to 6.056, 1.249 to 4.466 and 1.234 to 4.153; P<0.01 or <0.05). ROC curve analysis result showed that the cut-off value of miR-155-5p was 2.89, and the area under curve was 0.871 (95% CI 0.782 to 0.951), with a sensitivity of 86.1% and a specificity of 80.4%. Conclusions:Serum miR-155-5p is closely related to the clinical prognosis in sepsis patients with acute liver injury. It can be used as one of the potential prognostic indicators for patients, and is worthy of further clinical study and analysis.