Preliminary Study Of MiRNA In Diagnosis And Treatment Of Sepsis

BackgroundAlthough with the advancement of ICU monitoring and treatment technology and the popularization of evidence-based medical treatment guidelines,the mortality rate of sepsis has decreased,but it is still relatively high.Early diagnosis and treatment are the keys to improve the prognosis of patients with sepsis.Traditional indicators reflecting infection such as white blood cell count,erythrocyte sedimentation rate,C-reactive protein,procalcitonin do not fully meet the clinical demands.MicroRNA is a single-stranded RNA composed of about 19 to 25 nucleotides.MicroRNA may play a role in the occurrence and development of sepsis.Some microRNAs may be used as biomarkers for early diagnosis and severity judgment of sepsis,but there is no unified conclusion in the current research.ObjectiveTo screen out MicroRNAs with relatively comprehensive functions that are helpful for the diagnosis,severity judgment and treatment of sepsis.MethodPart one: Select 30 patients with sepsis hospitalized from June 2017 to February 2019 and divide them into without-septic-shock group and septic shock group according to the severity of the disease.Peripheral venous blood samples were collected within 24 hours after patients diagnosed with sepsis,and the samples were collected again after the condition improved significantly.The expression levels of miR-150,miR-146 a,miR-223 and miR-155 were detected by real-time fluorescent quantitative PCR,the content of PCT was detected by electrochemiluminescence immunoassay.Detect the content of WBC and calculate APACHE II score and SOFA score on the day of blood sampling.And compare the results.Part two: According to the first part of the experimental results,mi R-150 and miR-146 a show significant changes as the condition of sepsis has improved significantly.Thirty persons who were examined at hospital from February 2019 to December 2019 were selected as the control group,and their expressions of miR-150 and miR-146 a were detected and compared with those of sepsis stage.T-test,Wilcoxon test were used to analyze the differences among groups.Pearson or spearman correlation analysis of the correlation between the indicators.Chi square test was used for sex comparison between the two groups.ROC curve was used to analyze the value of miR-150 and miR-146 a in early diagnosis of sepsis.Results(1)There was no statistical difference in age and gender between the groups(P> 0.05).(2)The expression level of miR-146 a at the sepsis stage was significantly lower than sepsis-improved group and the control group(P <0.05).In addition,miR-146 a was significantly negatively correlated with APACHEII score and SOFA score.miR-146 a was not significantly different between the without-septic-shock group and the septic shock group(P> 0.05).(3)The expression level of miR-150 at the sepsis stage was significantly higher than that of sepsis-improved group and the control group(P <0.05).miR-150 was significantly lower in the without-septic-shock group than in the septic shock group(P <0.05).(4)There was no statistical difference between mi R-223 and miR-155 under the sepsis stage and the treatment-improvement stage(P> 0.05).(5)ROC curve analysis showed that the area under the curve and the 95% confidence interval of miR-150 as a diagnostic marker of sepsis were 0.81(0.69-0.90).When the cut-off value was 2.27,the sensitivity of diagnosing sepsis is 56.7% and specificity is 93.3%;miR-146 a as a diagnostic marker of sepsis and 95% confidence interval is 0.90(0.79-0.96),when the cut-off value is 1.43,the sensitivity of diagnosing sepsis is 96.7% and specificity is 73.3%.Conclusion(1)Serum miR-150 may have a high specificity for the diagnosis of sepsis,but the sensitivity is relatively insufficient,and it is positively correlated with the severity of sepsis.And it may be a potential target for treatment of sepsis.(2)Serum miR-146 a may have a high sensitivity and specificity for the diagnosis of sepsis,and it is negatively correlated with the severity of sepsis.And it may be a potential target for treatment of sepsis.