【摘要】 目的探 讨血浆外泌体源性miR-1224-5p与溃疡性结肠炎（ulcerative colitis,UC）患者炎性反应状态及预后的关系。方法 选择2018年1月-2019年10月海安市人民医院收治的103例UC患者，其中活动期57例，缓解期46例；选择同期来我院体检的60例健康人群作为对照组。采用实时荧光定量聚合酶链反应检测血浆外泌体源性miR-1224-5p表达量。比较各组血浆外泌体源性miR-1224-5p表达差异，采用Pearson相关分析探讨血浆外泌体源性miR-1224-5p与Mayo评分、Baron评分的相关性，多因素Logistic回归分析影响UC患者预后复发的相关因素。结果 活动期UC患者血浆外泌体源性miR-1224-5p明显高于缓解期患者与对照组，缓解期UC患者血浆外泌体源性miR-1224-5p明显高于对照组（P<0.05）。活动期重度组UC患者血浆外泌体源性miR-1224-5p、Mayo评分、Baron评分均明显高于中度组和轻度组，中度组UC患者血浆外泌体源性miR-1224-5p、Mayo评分、Baron评分均明显高于轻度组（P<0.05）。Pearson相关分析发现，血浆外泌体源性miR-1224-5p与Mayo评分、Baron评分均呈正相关（P<0.05）。活动期UC患者复发率（38.60%,22/57）明显高于缓解期UC患者（19.56%,9/46）（χ~2=4.382,P=0.036）。复发组UC患者血浆外泌体源性miR-1224-5p及Mayo评分、Baron评分均明显高于未复发组（P<0.05）。多因素Logistic回归分析显示，血浆外泌体源性miR-1224-5p、Mayo评分、Baron评分、疾病处于活动期均为影响UC复发的危险因素（P<0.05）。结论 溃疡性结肠炎患者血浆外泌体源性miR-1224-5p相对表达量明显升高，活动期UC患者血浆外泌体源性miR-1224-5更高，且与患者炎性反应程度呈正相关，同时是UC患者复发的相关因素。更多还原

【Abstract】 Objective To investigate the relationship between plasma exosome-derived miR-1224-5p,and inflammatory response status and prognosis of patients with ulcerative colitis(UC).Methods A total of 103 cases with UC admitted to our hospital from Jan 2018 to Oct 2019 were selected,of which 57 cases were in the active stage and 46cases were in the remission stage.At the same time,60 healthy people who came to our hospital for physical examination during the same period were selected as the control group.Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of plasma exosomes-derived miR-1224-5p.The differences of the expression of plasma exosome-derived miR-1224-5p in two group were compared.Pearson correlation analysis was used to explore the correlation between plasma exosome-derived miR-1224-5p and Mayo score,Baron score.Multivariate logistic regression analysis was used to explore the influence factors for recurrence of UC cases,and the stepwise method was used to select features.Results The level of plasma exosome-derived miR-1224-5p in cases with active UC was significantly higher than that of in patients in remission stage and the control group,and the level of plasma exosome-derived miR-1224-5p of UC patients in remission stage was significantly higher than that of in the control group(P value<0.05).The level of plasma exosome-derived miR-1224-5p,Mayo score,and Baron score of severe UC patients in the active stage were significantly higher than those in UC patients in the moderate and mild stages,and the level of plasma exosome-derived miR-1224-5p,Mayo score,and Baron score were significantly higher than those of UC patients in the mild stage(P value<0.05).Pearson correlation analysis found that plasma exosomal-derived miR-1224-5p was positively correlated with Mayo score,Baron score(P value<0.05).The recurrence rate of active UC patients (38.60%,22/57)was significantly higher than that of in the remission UC patients (19.56%,9/46)(χ~2=4.382,P value=0.036).Plasma exosome-derived miR-1224-5p,Mayo score and Baron score in the relapsed group of UC patients were significantly higher than those in the non-relapsed group(P value<0.05).Multivariate logistic regression analysis showed that plasma exosome-derived miR-1224-5p,Mayo score,Baron score and disease in the active stage were risk factors for recurrence of UC(P value<0.05).Conclusion The relative expression of plasma exosome-derived miR-1224-5p in patients with ulcerative colitis is significantly increased,and the plasma exosome-derived miR-1224-5 in patients with active UC is higher.It is positively correlated with the degree of inflammatory response in patients,and it is a risk factor for recurrence of UC patients.更多还原