目的 探究老年多重耐药菌感染肺炎患者微小核糖核酸（miR）-127-5p、miR-127、miR-155表达水平，并分析其与免疫相关细胞因子的相关性。 方法 选取2020年6月到2022年6月本院收治的65例老年多重耐药菌感染肺炎患者作为观察组，并选取同期健康体检人员80例作为对照A组和同期收治的老年普通肺炎患者80例作为对照B组。比较三组血清miR-127-5p、miR-127、miR-155表达水平和γ干扰素（IFN-γ）、白细胞介素（IL）-4、IL-17、转化生长因子-β（TGF-β）水平，采用Pearson相关分析血清miR-127-5p、miR-127和miR-155表达水平与免疫相关细胞因子的相关性，采用受试者工作特征曲线（ROC）分析三者单独及联合对老年多重耐药菌感染肺炎的诊断价值。 结果 对照B组和观察组血清miR-127-5p、IFN-γ水平低于对照A组，且观察组低于对照B组（P < 0.05）；而对照B组和观察组血清miR-127、miR-155、IL-4、IL-17、TGF-β水平高于对照A组，且观察组高于对照B组（P < 0.05）。血清miR-127-5p表达水平与血清IFN-γ水平呈正相关（r = 0.463，P < 0.05），与血清IL-4、IL-17、TGF-β水平呈负相关（r = -0.378、-0.396、-0.408，P < 0.05）；而血清miR-127和miR-155表达水平与血清IFN-γ水平呈负相关（r = -0.267、-0.513，P < 0.05），与血清IL-4、IL-17、TGF-β水平呈正相关（r = 0.306、0.273、0.330和r = 0.410、0.453、0.385，P < 0.05）。血清miR-127-5p、miR-127和miR-155表达水平单独及联合诊断对老年多重耐药菌感染肺炎具有一定的诊断价值，其AUC值分别为0.811、0.733、0.817、0.906，敏感度为90.77%、60.00%、67.69%、84.62%，特异度为66.87%、80.62%、83.75%、83.18%。 结论 miR-127-5p、miR-127和miR-155在老年多重耐药菌感染肺炎患者中差异性表达，与免疫相关细胞因子具有一定的相关性，三者联合检测对老年多重耐药菌感染肺炎具有较好的诊断价值。

Objective To explore the expression levels of ribonucleic acid （miR）-127-5p， miR-127 and miR-155 in elderly patients with pneumonia infection by multidrug-resistant bacteria and their correlation with immune-related cytokines. Methods 65 elderly patients with pneumonia infection by multidrug-resistant bacteria， 80 healthy physical examination persons and 80 elderly patients with common pneumonia in our hospital from June 2020 to June 2022 were retrospectively selected as the observation group， the control group A and the control group B， respectively. The expression levels of miR-127-5p， miR-127， miR-155， interferon-γ （IFN-γ）， interleukin （IL-4）， IL-17， and transforming growth factor-β （TGF-β） in serum samples were detected and compared among the three groups. Pearson correlation analysis analyzed the correlation between miR-127-5p， miR-127， miR-155 and IFN-γ， IL-4， IL-17， TGF-β， and the Receiver operating characteristic curve （ROC） analyzed the diagnostic value of miR-127-5p， miR-127， miR-155 alone or in combination. Results The serum levels of miR-127-5p and IFN-γ in the control group B and the observation group were lower than those in the control group A， and the both in the observation group were lower than the both in the control group B （P < 0.05）. The serum levels of miR-127， miR-155， IL-4， IL-17， and TGF-β in the control group B and observation group were higher than those in the control group A， and those in the observation group were higher than those in the control group B （P < 0.05）. There was a positive correlation between serum miR-127-5p and serum IFN-γ levels （r = 0.463， P < 0.05）， serum miR-127 and IL-4， IL-17 or TGF-β levels （r = 0.306， 0.273 or 0.330， P < 0.05）， and serum miR-155 and IL-4， IL-17 or TGF-β levels （r = 0.410， 0.453 or 0.385， P < 0.05）， and as well as a negative correlation between serum miR-127-5p and IL-4， IL-17 or TGF-β （r = -0.378， -0.396 or -0.408， P < 0.05）， serum miR-127 or miR-155 and IFN-γ levels （r = -0.267 or -0.513， P < 0.05）. Serum miR-127-5p， miR-127 and miR-155 expression levels alone and in combination have a certain diagnostic value in elderly patients with pneumonia infection by multi-drug resistant bacteria， and the area under ROC curve （AUC） values were 0.811， 0.733， 0.817 and 0.906， and the sensitivities were 90.77%， 60.00%， 67.69%， 84.62%， and the specificities were 66.87%， 80.62%， 83.75%， 83.18%. Conclusion MiR-127-5p， miR-127 and miR-155 were differentially expressed in the elderly patients with pneumonia infection by multi-drug resistant bacteria， and were correlated with immune-related cytokines to a certain extent， and the combination of the three has a good diagnostic value， thus may providing a new target for clinical diagnosis of this disease.