碳青霉烯类抗生素联合血液滤过在脓毒性休克患者中的应用及对血清lncRNA XIST和miRNA-130a水平的影响

doi:10.3969/j.issn.1006-5725.2025.06.014

Abstract

Abstract:

Objective To evaluate the application of carbapenem antibiotics in conjunction with hemofiltration for patients with septic shock and to analyze the impact on serum levels of lncRNA XIST and miRNA-130a. Methods A prospective study was conducted on 80 patients with septic shock treated at our hospital from August 2022 to January 2024. These patients were randomly divided into a control group and an experimental group， each comprising 40 cases. The control group received carbapenem antibiotics， while the experimental group received carbapenem antibiotics in combination with hemofiltration. The clinical outcomes of both groups were evaluated， and comparisons were made regarding their hemodynamic indices ［including cardiac output （CO）， central venous pressure （CVP）， and mean arterial pressure （MAP）］， immune function indices ［including interleukin-6 （IL-6）， C-reactive protein （CRP）， and tumor necrosis factor-alpha （TNF-α）］， oxygen metabolism indices ［including blood oxygen saturation （SaO₂）， blood lactate （LAC）， and oxygenation index （PaO₂/FiO₂）］， as well as serum levels of lncRNA XIST and miRNA-130a expression. Results Following treatment， the levels of CO， CVP， MAP， SaO₂， PaO₂/FiO₂， and miRNA-130a were significantly increased， whereas the levels of IL-6， CRP， TNF-α， LAC， and lncRNA XIST were significantly decreased compared to pre-treatment levels （all P < 0.05）. In comparison with the control group， the experimental group exhibited significantly higher levels of CO， CVP， MAP， and miRNA-130a， as well as significantly lower levels of IL-6， CRP， TNF-α， and lncRNA XIST （all P < 0.05）. The overall effective rate in the experimental group was significantly higher than that in the control group （χ ² = 4.501， P < 0.05）， while no significant difference was observed in the incidence of adverse reactions between the two groups （χ ² = 0.180， P > 0.05）. Conclusion Carbapenem antibiotics and hemofiltration therapy can alleviate the symptoms of septic shock patients by downregulating lncRNA XIST expression， upregulating miRNA-130a expression， modulating inflammatory factors， enhancing oxygen metabolism indices， and maintaining hemodynamic stability.

Key words: serum lncRNA XIST, miRNA-130a, carbapenem antibiotics, hemofiltration therapy, septic shock

CLC Number:

R459.7

Wenchi ZENG,Yuanli ZHANG,Mingdi CHEN,Hongyu DONG,Jinzhao. BAI. Carbapenem antibiotics combined with haemofiltration in patients with septic shock and the effect on serum lncRNA XIST and miRNA⁃130a[J]. The Journal of Practical Medicine, 2025, 41(6): 866-871.

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References 26

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组别	CO/（L/min）		CVP/（mmHg）		MAP/（mmHg）
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组（n = 40）	2.45 ± 0.33	4.21 ± 0.51^?	4.79 ± 0.57	7.04 ± 1.14^?	51.22 ± 6.48	70.56 ± 9.74^?
观察组（n = 40）	2.43 ± 0.28	5.49 ± 0.58^?	4.80 ± 0.64	11.66 ± 2.16^?	50.26 ± 7.46	90.82 ± 8.37^?
t值	0.292	10.486	0.076	12.020	0.615	9.972
P值	0.771	< 0.001	0.940	< 0.001	0.540	< 0.001

组别	IL-6/（ng/L）		CRP/（mg/L）		TNF-α/（mg/L）
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组（n = 40）	350.65 ± 55.88	274.46 ± 40.19^?	75.04 ± 7.40	45.06 ± 5.39^?	65.46 ± 8.44	44.23 ± 4.87^?
观察组（n = 40）	348.77 ± 57.37	210.71 ± 38.22^?	76.61 ± 6.98	22.45 ± 3.67^?	64.39 ± 7.85	20.38 ± 5.12^?
t值	0.149	7.270	0.976	21.925	0.587	21.359
P值	0.882	< 0.001	0.332	< 0.001	0.559	< 0.001

组别	lncRNA XIST		miRNA-130a
组别	治疗前	治疗后	治疗前	治疗后
对照组（n = 40）	2.38 ± 0.12	1.15 ± 0.05^?	0.33 ± 0.05	0.74 ± 0.06^?
观察组（n = 40）	2.40 ± 0.10	1.00 ± 0.04^?	0.32 ± 0.06	0.93 ± 0.07^?
t值	0.785	13.501	0.620	14.040
P值	0.435	< 0.001	0.537	< 0.001

组别	SaO₂/%		LAC/（mmol/L）		PaO₂/FiO₂/mmHg
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组（n = 40）	82.26 ± 2.11	90.78 ± 3.21^?	14.26 ± 1.36	9.62 ± 1.29^?	335.50 ± 20.17	402.22 ± 25.38^?
观察组（n = 40）	82.78 ± 2.34	95.45 ± 2.05^?	14.05 ± 1.48	6.37 ± 1.24^?	336.47 ± 20.28	422.26 ± 25.06^?
t值	1.0607	7.774	0.631	11.479	0.212	3.554
P值	0.292	< 0.001	0.530	< 0.001	0.832	0.001

组别	显效	有效	无效	总有效率
对照组（n = 40）	12（30.00）	18（45.00）	10（25.00）	30（75.00）
观察组（n = 40）	18（45.00）	19（47.50）	3（7.50）	37（92.50）
χ² 值				4.501
P值				0.034

Carbapenem antibiotics combined with haemofiltration in patients with septic shock and the effect on serum lncRNA XIST and miRNA⁃130a

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