摘要
目的:探讨血浆微小核糖核酸-101(miR-101)水平与慢性阻塞性肺疾病(COPD)急性加重期并呼吸衰竭患者气道反应性的关系。方法:选取2017年2月—2019年3月本院收治的186例COPD急性加重期并呼吸衰竭患者进行研究,逆转录—聚合酶链反应法(RT-PCR)检测所有研究对象血浆miR-101水平。利用脉冲振荡肺功能测定气道高反应性;Logistic回归分析探讨血浆miR-101与气道高反应性的关系;制作受试者工作特征曲线(ROC),分析血浆miR-101水平对气道高反应性是否发生的评估效能。结果:本研究中有68例发生气道高反应性,发生率为36.56%;气道高反应性组患者血浆miR-101表达水平明显高于气道正常组(P<0.05)。气道高反应性组吸烟、COPD病程>5年、遗传因素、呼吸道感染、气道炎症、血浆miR-101水平>1.0构成比均显著高于气道正常组(P<0.05);2组患者肺功能损伤程度分布差异显著(P<0.05),气道高反应组肺功能重度损伤、肺功能极重度损伤构成比均显著高于气道正常组(P<0.05);经Logistic回归分析可知,吸烟、COPD病程>5年、遗传、呼吸道感染、气道炎症、肺功能重度损伤、肺功能极重度损伤、血浆miR-101>1.0均是影响气道高反应发生的独立危险因素(P<0.05)。受试者工作特征曲线(ROC)分析显示,血浆miR-101评估发生气道高反应性的最佳截断点为0.81,灵敏度为86.76%,特异度为73.73%,准确度为78.49%,曲线下面积(AUC)为0.851。结论:血浆miR-101在气道高反应患者中呈高表达,可用于评估COPD急性加重期并呼吸衰竭患者是否发生气道高反应性。
Objective:To investigate the relationship between the plasma micro ribonucleic acid-101(miR-101)level and the airway reactivity in patients with acute exacerbation of COPD and respiratory failure.Methods:186 patients with acute exacerbation of COPD and respiratory failure admitted to our hospital from February 2017 to March 2019 were selected for study.The plasma miR-101 level of all subjects was detected by Reverse transcription polymerase chain reaction(RT-PCR).Measurement of airway hyperresponsiveness by impulse oscillation pulmonary function.The relationship between plasma miR-101 and airway hyperresponsiveness by logistic regression analysis.The receiver operating characteristic curve(ROC)of subjects was made to analyze the evaluation effect of plasma miR-101 level on the occurrence of airway hyperresponsiveness.Results:There were 68 cases of airway hyperresponsiveness in this study,the incidence was 36.56%.The expression level of miR-101 in patients with airway hyperresponsiveness group was significantly higher than that in patients with normal airway group(P<0.05).The proportion of smoking,COPD course>5 years,genetic factors,respiratory tract infection,airway inflammation and miR-101 level>1.0 in the airway hyperresponsiveness group was significantly higher than that in the normal airway group(P<0.05).There was a significant difference in the degree of lung function injury between the two groups(P<0.05),and the proportion of severe injury and extremely severe injury in the airway hyperresponsiveness group were significantly higher than those in normal airway group(P<0.05).According to logistic regression analysis,smoking,COPD course>5 years,heredity,respiratory tract infection,airway inflammation,severe injury of lung function,extremely severe injury of lung function,and plasma miR-101>1.0 were all independent risk factors(P<0.05).Receiver operating characteristic curve(ROC)analysis showed that the best cutoff point of miR-101 was 0.81,the sensitivity was 86.76%,the specificity was 73.73%,the accuracy was 78.49%,and the area under the curve(AUC)was 0.851.Conclusion:Plasma miR-101 is highly expressed in patients with airway hyperresponsiveness,which can be used to evaluate whether airway hyperresponsiveness occurs in patients with acute exacerbation of COPD and respiratory failure.
作者
杜发强
DU Faqiang(The People’s Hospital of Zhoukou City,He’nan Province 466000)
出处
《医学理论与实践》
2022年第2期198-201,共4页
The Journal of Medical Theory and Practice
