Dynamic Monitoring Of Plasma MiR-146a Expression In Patients With Sepsis And Its Value Of Diagnosis,Evaluation And Prognosis

Object:To investigate the role of mi R-146 a in the diagnosis,evaluation of disease and prognosis of sepsis.Methods:Coagulated blood samples were collected from 54 sepsis patients and another 30 healthy subjects were collected as normal controls.All patients were admitted between February 2016 and January 2017 at people's Hospital of Shihezi.Based on 28-day mortality,sepsis patients were divided into survivors(n=36)and non-survivors(n=18).We collected blood samples on day 0,1,2,3,7 and examinate mi R-146,IL-1,IL-6,IL-10,PCT,CRP,and assessed the clinical data including APACHE? and SOFA score.Put mi R-146 a and the other significant different expresstion biomarkers in to ROC to compare the diagnosis and prognosis value.Results:(1)Expression levels of mi R-146 a and CRP in sepsis patients increased at first and then decreased,CRP peaked at D1,and mi R-146 a peaked at D2,while the remaining indexes showed a downward trend.(2)Expression levels of mi R-146 a,IL-6,PCT,CRP in patients with sepsis were higher than control group in D0-D7;the level of IL-1 was higher than healthy people in D0-D3;the level of IL-10 was higher than in healthy D0,D1,D7 lower than that of healthy people(P< 0.05);other time points had no difference between the two groups(P ? 0.05).(3)The diagnosis value of sepsis was compared by AUC,PCT ?mi R-146a?CRP?IL-1?IL-6?IL-10.The AUC of mi R-146 a was 0.92(95%CI,0.87-0.98),the cut-off value was 14.25,and the sensitivity and specificity were 81.5% and 90% respectively.(4)The level of mi R-146 a,IL-1,IL-6,PCT,CRP,APACHE? score and SOFA score of septic shock group was higher than sepsis group in D0-D7,the level of IL-10 infection in D0-D2 shock group than sepsis group,the difference was statistically significant(P ? 0.01);other time points had no difference between the two groups(P?0.05).(5)Tthe expression levels ofmi R-146 a were positively correlated with the SOFA score in D0,but not significantly related to the APACHE? score.(6)Levels of PCT,IL-1,APACHE? score and SOFA score of death groupwere higher than that of the survival group in D0-D7;the level of CRP D0-D2 was higher than the survival group,the difference was statistically significant(P?0.05);other time points had no difference between the two groups(P?0.05);levels of mi R-146 a,IL-6,IL-10 were not significantly different between the two groups in D0-D7(P?0.05);(7)The index to predict the mortality of sepsis AUC comparison,SOFA?PCT?APACHE??IL-1?CRP?IL-10?IL-6?mi R-146 a.The AUC of mi R-146 a is 0.539(95%CI,0.366-0.711).Conclusions: 1.The value of mi R-146 a in the diagnosis of sepsis is high,miR-146 a may be a biomarker for the diagnosis of sepsis.2.The value of mi R-146 a in the prognostic of sepsis is low.3.The expression level of mi R-146 a may be related to the severity of sepsis.