摘要 目的 探讨血清微小核糖核酸-27a(miR-27a)、微小核糖核酸-27b(miR-27b)水平及肺栓塞严重程度指数（PESI）对急性肺栓塞（APE）患者预后的评估价值。〖HTH〗方法〓〖HTSS〗选取2016年1月至2018年6月海口市第三人民医院收治的APE患者160例，根据APE患者28 d生存情况分为存活组（n=115）和死亡组（n=45）。采用PESI评分标准将APE患者分为低危组（n=34）、中危组（n=68）和高危组（n=58）。采用实时荧光定量聚合酶链反应(RT-PCR)检测各组血清miR-27a及miR-27b水平变化。应用ROC曲线分析血清miR-27a、miR-27b水平及PESI对APE患者的预后评估价值，采用Pearson相关分析APE患者血清miR-27a、miR-27b水平与PESI的相关性。 结果 死亡组血清miR-27a（4.26±0.93 vs. 1.95±0.42）、miR-27b（3.72±0.75vs. 1.63±0.51）水平及PESI评分（164.70±28.60 vs. 93.50±14.30）均明显高于存活组（P<0.01）。高危组血清miR-27a（3.94±0.85 vs. 2.87±0.62, 1.52±0.34）、miR-27b（3.60±0.71 vs. 2.26±0.54, 1.18±0.20）水平及PESI评分（158.50±26.40 vs. 102.40±18.50, 75.20±10.70）均明显高于中危组和低危组（P<0.01）。ROC曲线分析显示，血清miR-27a、miR-27b水平及PESI评分预测APE死亡的最佳截值分别为3.45、2.96、135.70分，三者联合预测APE患者死亡的AUC［0.862（0.803～0.926）］最大，其敏感度和特异度为87.2%和82.5%。相关分析显示，死亡组血清miR-27a、miR-27b水平与PESI均呈正相关（r=0.795、r=0.718，P<0.01），miR-27a水平与miR-27b水平呈正相关（r=0.746，P<0.01）。 结论 miR-27a及miR-27b表达上调与APE患者预后相关，miR-27a及miR-27b联合PESI可有效评估APE患者的预后。
许玫莎，王聪，郑友峰，吴挺实，肖成钦，陈伟. miR-27a miR-27b及肺栓塞严重程度指数对急性肺栓塞患者预后的评估价值[J]. 中国急救医学, 2019, 39(5): 471-475.
Xv Mei-sha, Wang Cong, Zheng You-feng, Wu Ting-shi, Xiao Cheng-qin, Chen Wei. Prognostic value of miR-27a, miR-b and PESI in the patients with acute pulmonary embolism. Chinese Journal of Critical Care Medicine, 2019, 39(5): 471-475.
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