关键词: 脓毒症, 循环微RNA, 预后

Abstract: Objective To investigate the relationship of serum microRNA-133a (miR-133a) and microRNA-182-5p (miR-182-5p) with intestinal barrier and prognosis in patients with sepsis. 
Methods A total of 150 patients with sepsis admitted to our hospital were selected and divided into mild to moderate sepsis group (n=79) and severe sepsis group (n=71) according to acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and the guidelines for clinical symptoms of sepsis on admission. According to the prognosis of the patients within 30 d, the patients were divided into the survival group  (n=102) and the death group (n=48). Fasting venous blood samples were collected from patients on admission, and the expression levels of serum miR-133a and miR-182-5p were detected by real-time fluorescence quantitative PCR (RT-qPCR). The levels of intestinal barrier function indicators including serum intestinal fatty acid binding protein (IFABP), diamine oxidase (DAO), and D-lactic acid (D-LAC) were detected by enzyme-linked immunosorbent assay (ELISA). The relationship of serum miR-133a and miR-182-5p expression with intestinal barrier and prognosis in patients with sepsis was analyzed. 
Results The intestinal barrier function indicators serum IFABP, DAO, and D-LAC as well as serum miR-133a levels in mild to moderate sepsis group were lower than those in severe sepsis group (t=39.268, 11.414, 13.187, 3.815, all P＜0.05), while serum miR-182-5p levels were higher than those in severe sepsis group patients (t=130.137, P＜0.05). The results of Pearson correlation analysis showed that serum miR-133a levels were positively correlated with IFABP, DAO, and D-LAC (r=0.421, 0.437, 0.507，all P＜0.01), and serum miR-182-5p levels were negatively correlated with IFABP, DAO, and D-LAC (r=-0.433, -0.462, -0.497，all P＜0.01). The serum miR-133a level in the survival group was lower than that in the death group (t=10.126, P＜0.05), while the serum miR-182-5p level was higher than that in the death group (t=23.979, P＜0.05). With prognosis as the dependent variable (1=death, 0=survival), and serum miR-133a and miR-182-5p as independent variables, multivariate Logistic regression analysis showed elevated miR-133a (OR=2.303, 95%CI: 1.453-3.650) and decreased miR-133a (OR=1.772, 95%CI: 1.167-2.690), which were closely related to the prognosis of patients with sepsis (P＜0.05). 
Conclusion Serum miR-133a is increased and miR-182-5p is decreased in patients with sepsis, and their levels are closely related to the intestinal barrier function of patients, which has important reference value for the evaluation of patients′ condition and prognosis. 

Key words: sepsis, circulating microRNA, prognosis