Abstract:

Objective　To explore the clinical value of miR-16-5p combined with plasma zonula occludens-1 (ZO-1) detection in predicting the prognosis in patients with infectious shock. Methods　A total of 137 patients with infectious shock admitted to Xi'an Union Hospital from January 2021 to August 2023 were retrospectively analyzed. There were 77 males and 60 females, aged 40 to 80 years. The levels of miR-16-5p and ZO-1 were detected. According to the 28-day survival, the patients were divided into a poor prognosis group (53 cases) and a good prognosis group (84 cases). Binary logistic regression analysis was used to analyze the risk factors affecting the patients' prognosis, and the receiver operating characteristic curve (ROC) was used to analyze the predictive value of miR-16-5p and ZO-1 for the patients' prognosis. ��² test and independent sample t test were used. Results　Univariate analysis showed that the proportion of age ≥60 years old, C-reactive protein (CRP), procalcitonin (PCT), Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score, and miR-16-5p and ZO-1 levels in the poor prognosis group were higher than those in the good prognosis group (all P<0.05). Binary logistic regression analysis showed that PCT (OR=1.783, 95%CI: 1.124-2.826), APACHEⅡ score (OR=3.011, 95%CI: 1.293-7.007), miR-16-5p (OR=4.628, 95%CI: 2.223-9.632), and ZO-1 (OR=4.287, 95%CI: 1.915-9.594) were independent risk factors for poor prognosis in patients with infectious shock (all P<0.05). ROC analysis results showed that the sensitivities of miR-16-5p, ZO-1, and their combination in predicting poor prognosis of infectious shock patients were 75.50%, 71.70%, and 92.50%, the specificities were 72.60%, 70.20%, and 89.30%, and the areas under the curves (AUC) were 0.805, 0.810, and 0.921 (all P<0.05). Conclusion　miR-16-5p and ZO-1 are independent risk factors for poor prognosis in patients with infectious shock, and clinical combined detection of miR-16-5p and ZO-1 levels can better predict the patients' prognosis.

Key words:

Infectious shock, Prognosis, Plasma zonula occludens-1, miR-16-5p, Predictive value

摘要：

目的　探究miR-16-5p联合血浆闭锁小带蛋白1（ZO-1）检测在感染性休克患者预后预测中的临床价值。方法　回顾性分析西安工会医院在2021年1月至2023年8月间收治的137例感染性休克患者（男性77例，女性60例，年龄为40～80岁），检测患者miR-16-5p和ZO-1水平。根据患者28 d内存活情况将其分为预后不良组（53例）和预后良好组（84例），采用二元logistic回归分析法分析影响患者预后的危险因素，受试者操作特征曲线（ROC）分析miR-16-5p和ZO-1对患者预后的预测价值。行χ²检验、独立样本t检验。结果　单因素分析结果显示，预后不良组年龄≥60岁占比、C反应蛋白（CRP）、降钙素原（PCT）、序贯器官衰竭评估（SOFA）评分、急性生理学和慢性健康状况评价Ⅱ（APACHEⅡ）评分、miR-16-5p、ZO-1水平均高于预后良好组（均P<0.05）。二元logistic回归分析结果显示，PCT（OR=1.783，95%CI：1.124～2.826）、APACHEⅡ评分（OR=3.011，95%CI：1.293～7.007）、miR-16-5p（OR=4.628，95%CI：2.223～9.632）、ZO-1（OR=4.287，95%CI：1.915～9.594）是感染性休克患者预后不良的独立危险因素（均P<0.05）。ROC分析结果显示，miR-16-5p、ZO-1及二者联合预测感染性休克患者预后不良的灵敏度分别为75.50%、71.70%、92.50%，特异度分别为72.60%、70.20%、89.30%，曲线下面积（AUC）分别为0.805、0.810、0.921（均P<0.05）。结论　miR-16-5p和ZO-1是感染性休克患者预后不良的独立危险因素，临床通过联合检测miR-16-5p和ZO-1水平可较好地预测患者预后。

关键词:

感染性休克, 预后, 血浆闭锁小带蛋白1, miR-16-5p, 预测价值