脓毒症患儿外周血sFasL、单核细胞miR-147b表达情况及其与预后的关系

Expression of soluble factor-related apoptosis ligand in peripheral blood and microRNA-147b in monocytes in children with sepsis and their association with prognosis

摘要:

目的 探讨脓毒症患儿外周血可溶性凋亡相关因子配体（soluble factor-related apoptosis ligand, sFasL）、单核细胞微小RNA（micro-ribonucleic acid, miR）-147b表达情况及对预后的评估价值。方法 前瞻性纳入脓毒症患儿124例（脓毒症组）、普通感染儿童60例（感染组）和健康体检儿童60例（健康对照组），分析脓毒症患儿预后不良的独立危险因素，评价血清sFasL、单核细胞miR-147b对脓毒症患儿预后不良的预测价值。结果 健康对照组、感染组、脓毒症组血清sFasL水平、单核细胞miR-147b相对表达量逐渐升高（P<0.05）。多因素logistic回归分析显示，血清sFasL水平高、单核细胞miR-147b相对表达量高均与脓毒症患儿预后不良密切相关（P<0.05）。受试者操作特征曲线分析显示，血清sFasL水平、单核细胞miR-147b相对表达量联合预测脓毒症患儿预后的曲线下面积高于各指标单独预测（P<0.05）。结论 脓毒症患儿外周血sFasL水平、单核细胞miR-147b相对表达量明显升高，两项指标联合应用在脓毒症患儿预后评估中具有较高的临床价值。

Abstract:

Objective To investigate the expression of soluble factor-related apoptosis ligand (sFasL) in peripheral blood and microRNA-147b (miR-147b) in monocytes in children with sepsis and their value in assessing prognosis.Methods A prospective study was conducted on 124 children with sepsis (sepsis group), 60 children with common infections (infection group), and 60 healthy children undergoing physical examinations (healthy control group). The independent risk factors for poor prognosis in children with sepsis were analyzed, and the value of serum sFasL and monocyte miR-147b in predicting poor prognosis in children with sepsis was assessed.Results The serum level of sFasL and the relative expression of miR-147b in monocytes were highest in the sepsis group, followed by the infection group and the healthy control group (P<0.05). The multivariate logistic regression analysis showed that the serum level of sFasL and the relative expression of miR-147b in monocytes were closely associated with the poor prognosis of children with sepsis (P<0.05). The receiver operating characteristic curve analysis showed that the combination of serum sFasL level and relative expression of miR-147b in monocytes had a larger area under the curve compared to each indicator alone in predicting the prognosis of children with sepsis (P<0.05).Conclusions There are significant increases in the level of sFasL in peripheral blood and the relative expression of miR-147b in monocytes in children with sepsis. The combined use of these two indicators has relatively high clinical value in assessing the prognosis of children with sepsis.