Abstract:

Objective

To investigate the expression level of serum miR-146a in patients with sepsis complicated with acute lung injury （ALI） and its correlation with prognosis.

Methods

Sixty-nine patients with sepsis complicated with ALI admitted to Tongchuan People′s Hospital from January 2021 to December 2024 were selected. According to the survival status of the patients，they were divided into the control group 45 cases and the observation group 24 cases. The clinical data of the two groups of patients were compared，and univariate analysis was conducted. The factors with statistical significance were subjected to multivariate Logistic regression analysis. The correlation between the expression level of miR-146a and the Acute Physiology and Chronic Health Evaluation Ⅱ（APACHE Ⅱ） score was analyzed，and a receiver operating characteristic curve（ROC） was constructed to predict the performance of serum miR-146a in diagnosing the prognosis of patients with sepsis complicated with ALI.

Results

The observation group exhibited significantly higher APACHE Ⅱscores （28.74±11.59 vs. 19.38±9.46，P ＜0.05），Sequential Organ Failure Assessment （SOFA） scores（14.06±4.67 vs. 9.25±3.40，P＜0.05），Lung Injury Scores （LIS） （2.45±0.51 vs. 2.09±0.35，P＜0.05），C-reactive protein （CRP） levels （37.24±6.35 μg/ml vs. 26.67±4.51 μg/ml，P ＜0.05），and miR-146a expression levels （2.68±1.39 vs. 1.44±0.81，P＜0.05） compared to the control group. The incidence of septic shock was significantly higher in the observation group 24 cases （77.42%） than in the control group 11 cases（20.00%） ，P ＜0.05. Spearman correlation analysis revealed a positive association between miR-146a expression and APACHE Ⅱscores （r=0.259，P=0.016）. Multivariate logistic regression identified septic shock，higher APACHE Ⅱscores，SOFA scores，LIS scores，CRP levels，and elevated miR-146a expression as independent risk factors for poor prognosis （P＜0.05）. The area under the ROC curve （AUC） for serum miR-146a in predicting poor prognosis was 0.789 （95%CI： 0.681 ～0.897），with a sensitivity of 61.3% and specificity of 89.1%，indicating strong predictive value.

Conclusion

The expression of serum miR-146a in sepsis complicated with ALI is closely related to the prognosis of patients，and it can be used as a potential biomarker for judging the severity of the disease and predicting the prognosis.

Key words: Acute lung injury, Serum miR-146a, Sepsis, Prognosis