Abstract：Objective: To investigate the relationship between the expression levels of peripheral blood microRNA-1323 (miR-1323)/interleukin-6 (IL-6) inflammatory axis factors and prognosis, as well as their predictive significance in elderly patients with severe pneumonia (SP). Methods: A total of 158 elderly patients with SP admitted from August 2020 to August 2024 were selected and followed up for 30 days. According to the prognosis, they were divided into good prognosis group and poor prognosis group. The clinical data immediately after admission, the levels of miR-1323, IL-6 and soluble interleukin-6 receptor (sIL-6R) in peripheral blood on the next day of admission were compared between the two groups. Smooth curve fitting was used to analyze the correlation between the miR-1323/IL-6 inflammatory axis factors in peripheral blood and prognosis. Logistic regression analysis was conducted to identify the influencing factors of prognosis in elderly SP patients. Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) were used to evaluate the predictive value of the miR-1323/IL-6 inflammatory axis factors in peripheral blood for prognosis. Results: After a 30-day follow-up, 112 cases had a good prognosis, while 46 cases had a poor prognosis. The poor prognosis group had higher age, CPIS scores, and CRP levels, and a longer duration of mechanical ventilation than the good prognosis group (P<0.05). The levels of miR-1323, IL-6, and sIL-6R in peripheral blood were higher in the poor prognosis group than in the good prognosis group (P<0.05). Smooth curve fitting analysis showed a positive linear relationship between the levels of miR-1323, IL-6, and sIL-6R in peripheral blood and the risk of poor prognosis in elderly SP patients, with a gradual increase in the risk of poor prognosis as the levels of miR-1323, IL-6, and sIL-6R in peripheral blood increased (P<0.05). Logistic regression analysis showed that, both before and after adjusting for other factors, miR-1323, IL-6, and sIL-6R in peripheral blood were independent factors affecting the prognosis of elderly SP patients (P<0.05). ROC curve analysis revealed that the AUCs for predicting the prognosis of elderly SP patients using miR-1323, IL-6, and sIL-6R in peripheral blood were 0.727 (95%CI: 0.650-0.794), 0.749 (95%CI: 0.674-0.815), and 0.780 (95%CI: 0.707-0.842), with sensitivities of 63.04%, 63.04%, and 60.87%, respectively, and specificities of 75.89%, 79.46%, and 86.61%. The AUC for predicting the prognosis of elderly SP patients using a combination of the three factors was 0.881 (95%CI: 0.820-0.927), with a sensitivity of 71.74% and a specificity of 85.71%, significantly higher than that of individual factors (Z=2.888, 2.693, 2.075, P=0.004, 0.007, 0.038). Conclusion: The miR-1323/IL-6 inflammatory axis factor in peripheral blood has a positive linear relationship with the risk of poor prognosis in elderly patients with bacterial SP. It can be used as an independent predictor to help effectively predict the risk of poor prognosis in clinical practice, and the combined predictive value is more reliable.
孙逊, 王天轶, 桑荣霞, 高聪慧. 老年重症细菌性肺炎miR-1323/IL-6轴因子与预后的关系及预测意义[J]. 河北医学, 2025, 31(12): 2062-2067.
SUN Xun, WANG Tianyi, et al. Relationship between miR-1323/IL-6 Axis Factor and Prognosis in Elderly Patients with Severe Bacterial Pneumonia and the Predictive Significance. HeBei Med, 2025, 31(12): 2062-2067.
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2025, Vol. 31 
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