脓毒症急性肾损伤患者血清miR-146a USF2 sCD74水平与病情严重程度的相关性及对预后的影响

doi:10.3969/j.issn.1006-6233.2025.07.018

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Abstract Objective: To investigate the correlation between the levels of serum microRNA-146a (miR-146a), upstream stimulatory factor 2 (USF2), and soluble CD74 (sCD74) and the severity of disease in patients with sepsis-associated acute kidney injury (AKI), as well as their impact on prognosis. Methods: A total of 144 patients with sepsis-induced AKI from January 2022 to January 2024 in Qinhuangdao First Hospital were selected. Based on the 28-day prognosis, patients were categorized into the good prognosis group and the poor prognosis group. The clinical data, serum levels of miR-146a, USF2, and sCD74 were compared between the two groups. The Spearman correlation coefficient was used to analyze the correlation between serum miR-146a, USF2, and sCD74 and the severity of sepsis and AKI. The relationship between serum miR-146a, USF2, and sCD74 and prognosis was analyzed using partial correlation analysis. Receiver operating characteristic (ROC) curves were evaluated for the predictive value of each indicator for prognosis. Results: Severity of sepsis, severity of AKI, APACHE II, and SOFA scores in the poor prognosis group were higher than in the good prognosis group (P<0.05). The levels of serum miR-146a, USF2, and sCD74 in the poor prognosis group were higher than in the good prognosis group (P<0.05). The levels of serum miR-146a, USF2, and sCD74 in patients with sepsis shock were higher than those in patients with sepsis (P<0.05). The levels of serum miR-146a, USF2, and sCD74 in patients with severe AKI were higher than in patients with mild AKI (P<0.05). Serum miR-146a, USF2, and sCD74 were positively correlated with sepsis severity and AKI severity (P<0.05). Partial correlation analysis showed serum miR-146a, USF2, and sCD74 were significantly correlated with prognosis (P<0.05). ROC curve analysis showed that the AUC of serum miR-146a, USF2, and sCD74 for predicting the prognosis of patients with sepsis-induced AKI were 0.776, 0.751, and 0.780, respectively, with Youden indexes of 0.438, 0.406, and 0.479, and sensitivities of 64.58%, 64.58%, and 70.83%, respectively. The specificities were 79.17%, 76.04%, and 77.08%, respectively. The AUC of serum miR-146a, USF2, and sCD74 combined to predict the prognosis of patients with sepsis-induced AKI was 0.922, with a Youden index of 0.771, a sensitivity of 89.58%, and a specificity of 87.50%. This significantly improved the predictive value compared to each indicator alone (Z=3.741, 4.120, 3.192, all P<0.001). Conclusion: The levels of serum miR-146a, USF2, and sCD74 in patients with sepsis and AKI are significantly correlated with the severity of sepsis and AKI, and are independent predictors of prognosis, and the predictive value can be enhanced when combined with other tests.

Key words： Sepsis Acute kidney injury Microribonucleic acid-146a Upstream stimulating factor 2 Soluble CD74

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	ZHANG Meixiang
	ZUO Zhigang
	LIU Xiujuan

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ZHANG Meixiang,ZUO Zhigang,LIU Xiujuan. The Correlation between the Levels of Serum miR-146a USF2 and sCD74 and the Severity of the Disease in Patients with Sepsis-Induced Acute Kidney Injury and the Impact on Prognosis[J]. HeBei Med, 2025, 31(7): 1158-1164.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.07.018 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I7/1158

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