药物性肝损伤患者血清miR-21和miR-124a水平变化及其临床意义探讨*

doi:10.3969/j.issn.1672-5069.2023.01.012

摘要/Abstract

摘要： 目的探讨药物性肝损伤(DILI)患者血清微小RNA(miR)-21和miR-124a水平变化及其临床意义。方法 2019年3月～2022年3月我院收治的87例DILI患者和60例同期体检的健康人,采用实时荧光定量PCR法检测血清miR21和miR-124a mRNA水平,采用ELISA法检测核转录因子-κB(NF-κB)和白介素-6(IL-6)水平。结果在DILI发生时,血清ALT、AST、GGT和TBIL峰值水平分别为(143.6±51.8)U/L、(158.2±38.8)U/L、(131.6±26.8)U/L和(41.9±9.6)μmol/L;DILI患者血清miR-21、miR124a mRNA、NF-κB和IL-6水平分别为(1.4±0.3)、(2.6±0.4)、(3615.4±526.4)pg/ml和(12.7±1.8)pg/ml,均显著高于健康人【分别为(1.0±0.1)、(1.1±0.1)、(692.2±144.6)pg/ml和(3.4±0.7)pg/ml,P<0.05】;混合型DILI患者血清NF-κB和IL-6水平分别为(3874.5±282.5)pg/ml和(14.4±2.6)pg/ml,均显著高于肝细胞型DILI患者【分别为(3609.8±296.4)pg/ml和(12.6±1.5)pg/ml,P<0.05】或胆汁淤积型DILI患者【分别为(3437.2±253.7)pg/ml和(11.7±1.3)pg/ml,P<0.05】;混合型、肝细胞型和胆汁淤积型DILI患者血清miR-21和miR-124a水平无显著性差异(P>0.05)。结论 DILI患者血清miR21和miR-124a 水平随肝功能损伤的出现而升高,但在三型不同肝损伤类型患者其水平无显著性差异,对临床分型的判断无指导意义。

关键词: 药物性肝损伤, 微小RNA(miR)-21, miR-124a, 临床意义

Abstract: Objective The aim of this study was to explore the changes of serum microRNA (miR)-21 and miR-124a levels in patients with drug-induced liver injury (DILI) and their clinical implications. Methods 87 patients with DILI and 60 health persons proven by physical examination were enrolled in our hospital between March 2019 and March 2022. Serum miR-21 and miR-124a levels were detected by real-time fluorescence quantitative PCR, and serum nuclear transcription factor-κB (NF-κB) and interleukin-6 (IL-6) levels were determined by ELISA. Results Serum peak ALT, AST, GGT and bilirubin levels in patients with DILI in our series were (143.6±51.8)U/L, (158.2±38.8)U/L, (131.6±26.8)U/L and (41.9±9.6)μmol/L; serum miR-21, miR124a mRNA, NF-κB and IL-6 levels in patients with DILI were (1.4±0.3), (2.6±0.4), (3615.4±526.4)pg/ml and (12.7±1.8)pg/ml, all significantly higher than [(1.0±0.1), (1.1±0.1), (692.2±144.6)pg/ml and (3.4±0.7)pg/ml, respectively, P<0.05] in healthy persons; serum NF-κB and IL-6 levels in patients with mixed DILI were (3874.5±282.5)pg/ml and (14.4±2.6)pg/ml, both much higher than [(3609.8±296.4)pg/ml and (12.6±1.5)pg/ml, respectively, P<0.05] in patients with hepatocyte injury or [(3437.2±253.7)pg/ml and (11.7±1.3)pg/ml, respectively, P<0.05] in DILI patients with cholestasis; unfortunately, there were no significant differences as respect to serum miR-21 and miR-124a levels among patients with different clinical types (P>0.05). Conclusion Serum miR-21 and miR-124a levels in patients with DILI significantly increase as liver function test deteriorated, but their clinical implications is still under investigation.

Key words: Drug-induced liver injury, microRNA-21, microRNA-124a, Implications

林仕文, 韩锋, 魏玉, 陈文传. 药物性肝损伤患者血清miR-21和miR-124a水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2023, 26(1): 43-46.

Lin Shiwen, Han Feng, Wei Yu, et al. Changes of serum miR-21 and miR-124a levels in patients with drug-induced liver injury[J]. Journal of Practical Hepatology, 2023, 26(1): 43-46.

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药物性肝损伤患者血清miR-21和miR-124a水平变化及其临床意义探讨^*

Changes of serum miR-21 and miR-124a levels in patients with drug-induced liver injury

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