Prognostic value of pulmonary ultrasound score combined with plasma miR-21-3p expression in patients with acute lung injury.

purposeThe aim of this study was to explore the value of the combination between lung ultrasound score (LUS) and the expression of plasma miR-21-3p in predicting the prognosis of patients with acute lung injury (ALI). PATIENTS AND

methodsA total of 136 ALI patients were divided into survival (n = 86) and death groups (n = 50), or into low/middle-risk (n = 77) and high-risk groups (n = 59) according to APACHE II scores. Bioinformatics was used to explore the mechanism of action of miR-21-3p in humans. Real-time fluorescent quantitative PCR was used to detect the expression of miR-21-3p in plasma, and LUS was recorded. Receiver operator characteristic (ROC) curve and Pearson correlation were also used.

resultsThe LUS and expression level of plasma miR-21-3p in the death and high-risk groups were significantly higher than those in the survival and low/middle-risk groups (p < 0.01 and p < 0.05). miR-21-3p expression leads to pulmonary fibrosis and promotes the deterioration of ALI patients by regulating fibroblast growth factor and other target genes. ROC curve analysis showed that the best cutoff values for LUS and plasma miR-21-3p expression were 18.60 points and 1.75, respectively. LUS score and miR-21-3p combined predicted the death of ALI patients with the largest area under the curve (0.907, 95% CI: 0.850-0.964), with sensitivity and specificity of 91.6% and 85.2%, respectively. The expression level of plasma miR-21-3p was positively correlated with LUS in the death group (r = 0.827, p < 0.01).

conclusionLUS and expression level of miR-21-3p in plasma are correlated with the severity and prognosis of ALI patients, and their combination has a high value for the prognostic assessment of ALI patients.