摘要目的:探讨AP患者血清miR-148a-3p和miR-551b-5p的表达水平及其临床价值。方法:选取2017年1月至2020年9月间儋州市人民医院收治的152例AP患者的临床资料，根据病情严重程度将患者分为MAP组(70例)、MSAP组(40例)和SAP组(42例)，SAP组又根据患者预后情况分成生存组(25例)和死亡组(17例)。另选取50例体检健康者作为对照组。于患者发病当天采集空腹静脉血，采用实时定量PCR法检测各组血清miR-148a-3p和miR-551b-5p表达水平。绘制受试者工作特征曲线(ROC)，计算曲线下面积(AUC)，分析血清miR-148a-3p和miR-551b-5p表达水平对SAP预后判断的价值。采用Pearson法分析SAP患者血清miR-148a-3p与miR-551b-5p表达水平的相关性。结果:AP组患者血清miR-148a-3p和miR-551b-5p表达水平均明显高于对照组(3.18±1.27比0.96±0.28，1.94±0.85比0.51±0.12， P值均<0.001)。SAP组血清miR-148a-3p及miR-551b-5p表达水平均明显高于MSAP组、MAP组(4.36±1.70比2.84±1.10、2.50±0.92，2.80±1.04比1.68±0.53、1.42±0.45， P值均<0.001)。死亡组血清miR-148a-3p及miR-551b-5p表达水平均明显高于生存组(5.30±1.95比3.47±1.40，3.62±1.37比2.08±0.91， P值均<0.001)。ROC曲线分析显示，miR-148a-3p与miR-551b-5联合判断SAP预后的AUC值明显高于miR-148a-3p、miR-551b-5p单项指标[0.943(95% CI0.886～0.997)比0.860(95% CI0.797～0.924)、0.822(95% CI0.765～0.880)]，其灵敏度为98.3%，特异度为84.6%。相关分析显示，SAP患者血清miR-148a-3p与miR-551b-5p表达水平呈正相关( r＝0.835， P<0.001)。 结论:AP患者血清miR-148a-3p及miR-551b-5p表达水平明显升高，两者联合检测对判断SAP患者预后具有较好的价值。

abstractsObjective:To investigate the expression level and clinical value of serum miR-148a-3p and miR-551b-5p in patients with acute pancreatitis (AP).Methods:The clinical data of 152 patients with AP admitted to Danzhou people's Hospital from January 2017 to September 2020 were selected. According to the severity of their illness, they were divided into MAP group ( n=70), MSAP group ( n=40), and SAP group ( n=42). The SAP group was divided into survival group ( n=25) and death group ( n=17) according to the prognosis of the patients. Another 50 healthy people were selected as the control group. Fastening venous blood was collected on the day of onset, and the expression levels of serum miR-148a-3p and miR-551b-5p in each group were detected by real-time quantitative PCR. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was calculated. The expression levels of serum miR-148a-3p and miR-551b-5p were analyzed to evaluate the prognosis of SAP. The correlation between serum miR-148a-3p and miR-551b-5p expression levels in SAP patients was analyzed by Pearson method. Results:The expression levels of serum miR-148a-3p (3.18±1.27 vs 0.96±0.28) and miR-551b-5p (1.94±0.85 vs 0.51±0.12) in AP group were significantly higher than those in control group ( P<0.001). The expression levels of serum miR-148a-3p (4.36±1.70 vs 2.84±1.10, 2.50±0.92) and miR-551b-5p (2.80±1.04 vs 1.68±0.53, 1.42±0.45) in SAP group were significantly higher than those in MSAP group and MAP group ( P<0.001). The expression levels of serum miR-148a-3p (5.30±1.95 vs 3.47±1.40) and miR-551b-5p (3.62±1.37 vs 2.08±0.91) in death group were significantly higher than those in survival group ( P<0.001). ROC curve analysis showed that the AUC of the combination of miR-148a-3p and miR-551b-5 in judging the prognosis of SAP was significantly higher than that of the single index of miR-148a-3p and miR-551b-5[0.943(95% CI0.886-0.997) vs 0.860(95% CI0.797-0.924), 0.822(95% CI0.795-0.880)], with a sensitivity of 98.3% and specificity of 84.6%. Correlation analysis showed that there were positive correlation between the expression level of serum miR-148a-3p and miR-551b-5p in SAP patients ( r=0.835, P<0.001). Conclusions:The expression levels of miR-148a-3p and miR-551b-5p in serum of AP patients were significantly increased, and the combined detection of miR-148a-3p and miR-551b-5p had a good value in judging the prognosis of SAP.