重症急性胰腺炎miR-21-3p、RUNX3表达水平及对病情发展程度的预测 [中文引用][英文引用]

 【摘要】 目的：探析重症急性胰腺炎微小核糖核酸-21-3p（miR-21-3p）、RUNT相关转录因子3（RUNX3）表达水平及对病情发展程度的预测价值。方法：选择2020年3月至2022年3月，什邡市人民医院收治的100例急性胰腺炎患者作为研究对象，按病情的不同，分为对照组（50例，轻症急性胰腺炎）和观察组（50例，重症急性胰腺炎）。用实时荧光定量（PCR）法进行miR-21-3p表达水平的检测，用酶联免疫分析法进行RUNX3表达水平的检测。比较两组患者的miR-21-3p、RUNX3表达水平差异，应用Logistic回归分析法探析miR-21-3p、RUNX3与重症急性胰腺炎病情恶化的关系，绘制受试者工作特征（ROC）曲线分析miR-21-3p、RUNX3在重症急性胰腺炎病情恶化预测诊断中的应用价值。结果：观察组的miR-21-3p检测值显著高于对照组，RUNX3检测值显著低于对照组，差异有统计学意义（P<0.05）。存活者的miR-21-3p检测值低于死亡者，RUNX3检测值高于死亡者（P<0.05）；Logistic结果显示，miR-21-3p高表达是重症急性胰腺炎恶化（死亡）的危险因素，RUNX3高表达是重症急性胰腺炎恶化（死亡）的保护因素（P<0.05）。ROC曲线显示，miR-21-3p、RUNX3联合诊断预测重症急性胰腺炎恶化的AUC（0.835，95%CI 0.742~0.928）最大，灵敏度、特异度分别为83.33%、93.18%（P<0.05）。结论：miR-21-3p在重症急性胰腺炎病情恶化过程中呈高表达，RUNX3在重症急性胰腺炎病情恶化过程中呈低表达，两项指标联合诊断预测重症急性胰腺炎病情发展，可为患者的病情早期诊断提供一定作用。

 [Abstract]  Objective  To investigate the expression levels of microRNA-21-3p (miR-21-3p) and Runt-related transcription factor 3 (RUNX3) in severe acute pancreatitis and their predictive value for the progression of the disease. Methods  One hundred patients with acute pancreatitis admitted to Shifang People's Hospital between March 2020 and March 2022 were selected as research objects and divided into control group (n=50, mild acute pancreatitis) and observation group (n=50, severe acute pancreatitis) according to their disease conditions. Real-time fluorescence quantification polymerase chain reaction (PCR) was used to detect the expression level of miR-21-3p, and enzyme-linked immunoassay was used to detect the expression level of RUNX3. The differences in the expression levels of miR-21-3p and RUNX3 between the two groups were compared, and the relationships between miR-21-3p and RUNX3 and the deterioration of severe acute pancreatitis were analyzed by Logistic regression analysis. Receiver Operating characteristic (ROC) curve was drawn to analyze the application value of miR-21-3p and RUNX3 in predicting and diagnosing the deterioration of severe acute pancreatitis. Results  The level of miR-21-3p in the observation group was significantly higher than that in the control group, and the level of RUNX3 in the observation group was significantly lower than that in the control group, with statistically significant differences (P<0.05). The miR-21-3p level in survivors was lower than that in deaths, while the RUNX3 level in survivors was higher than that in deaths (P<0.05). Logistic results showed that the high expression of miR-21-3p was a risk factor for the worsening (death) of severe acute pancreatitis, and the high expression of RUNX3 was a protective factor for the worsening (death) of severe acute pancreatitis (P<0.05). ROC curve showed that the AUC (0.835, 95%CI: 0.742-0.928) of the combined diagnosis of miR-21-3p and RUNX3 in predicting the deterioration of severe acute pancreatitis was the largest, and the sensitivity and specificity were 83.33% and 93.18% (P<0.05), respectively. Conclusion  miR-21-3p is highly expressed in the worsening process of severe acute pancreatitis, and RUNX3 is lowly expressed in the worsening process of severe acute pancreatitis. The combined diagnosis of the two indexes can predict the development of severe acute pancreatitis, which can provide a certain auxiliary role for the early diagnosis of patients.