2026 年第 8 期 第 21 卷

老年肺炎患者血清微小RNA-155和微小RNA-1323水平检测及临床意义研究

Detection and clinical significance of serum microRNA-155 and microRNA-1323 levels in elderly patients with pneumonia

作者：王忠祥庄雪明张烨

英文作者：Wang Zhongxiang Zhuang Xueming Zhang Ye

单位：中国人民解放军联勤保障部队第九〇四医院急诊科，无锡214044

英文单位：Department of Emergency the 904th Hospital of Joint Logistics Support Force of the Chinese People′s Liberation Army Wuxi 214044 China

关键词：老年重症肺炎；微小RNA-155；微小RNA-1323；炎症指标

英文关键词：Elderlyseverepneumonia;MicroRNA-155;MicroRNA-1323;Inflammatoryindicators

• 摘要：

• 目的 探讨血清微小RNA-155（miR-155）、miR-1323在老年肺炎患者中的表达水平，分析其与炎症指标及疾病诊断的关系。方法 纳入2023年1月至2025年1月中国人民解放军联勤保障部队第九〇四医院收治的老年肺炎患者169例，根据肺炎判定标准将其分为轻症肺炎组（116例）和重症肺炎组（53例）。并选取同期年龄匹配的健康老年人为对照组（55例）。采用Pearson分析法分析血清miR-155、miR-1323水平与临床参数相关性；二元Logistic回归分析重症肺炎的影响因素；受试者工作特征（ROC）曲线评估血清指标对重症肺炎的诊断价值。结果 轻症肺炎组与重症肺炎组的降钙素原、C反应蛋白（CRP）及白细胞介素6（IL-6）水平均显著高于对照组，且重症肺炎组各指标水平均高于轻症肺炎组（均P＜0.05）。miR-155表达水平在重症肺炎组最高，轻症组次之，对照组最低；而miR-1323表达水平则呈现相反趋势，在重症肺炎组最低（均P＜0.05）。血清miR-155与降钙素原、CRP、IL-6呈正相关（r=0.229、P=0.003，r=0.203、P=0.008，r=0.358、P＜0.001）。相反，血清miR-1323与上述炎症指标呈负相关（r=-0.351、-0.331、-0.301，均P＜0.001）。降钙素原、CRP、IL-6、miR-155是老年重症肺炎发生的独立危险因素，miR-1323是保护因素（均P＜0.05）。miR-1323单项检测对重症肺炎具有极高的敏感度（98.1%，曲线下面积为0.861），而miR-155单项检测则表现出高特异度（90.5%，曲线下面积=0.761）。两者联合检测实现了敏感度（73.6%）与特异度（87.1%）的最佳平衡，诊断效能最高（曲线下面积=0.885）。结论 血清miR-155水平升高和miR-1323水平降低是老年重症肺炎的显著特征，两者失衡状态与疾病严重程度密切相关。联合检测miR-155与miR-1323对老年重症肺炎具有较高的诊断价值，有望成为传统炎症标志物的有益补充，为临床早期识别高危患者提供新的分子依据。

• Objective To investigate the serum expression levels of microRNA-155 (miR-155) and miR-1323 in elderly patients with pneumonia, and analyze their correlations with inflammatory markers and diagnostic value. Methods A total of 169 elderly patients with pneumonia admitted to the 904th Hospital of Joint Logistics Support Force of the Chinese People′s Liberation Army from January 2023 to January 2025 were enrolled and divided into mild pneumonia group (116 cases) and severe pneumonia group (53 cases) according to diagnostic criteria of pneumonia. Meanwhile, 55 age-matched healthy elderly subjects were selected as control group. Pearson correlation analysis was adopted to analyze the correlations of serum miR-155 and miR-1323 with clinical parameters; binary Logistic regression was used to explore independent risk factors for severe pneumonia; receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficiency of serum indicators for severe pneumonia. Results The levels of procalcitonin, C-reactive protein (CRP) and interleukin-6 (IL-6) in mild and severe pneumonia groups were significantly higher than those in control group, and all above indicators were elevated in severe pneumonia group compared with mild pneumonia group (all P＜0.05). The expression level of miR-155 was the highest in severe pneumonia group, followed by mild pneumonia group and control group, whereas miR-1323 showed an opposite trend with the lowest level in severe pneumonia group (all P＜0.05). Serum miR-155 was positively correlated with procalcitonin, CRP and IL-6 (r=0.229, P=0.003; r=0.203, P=0.008; r=0.358, P＜0.001). In contrast, serum miR-1323 was negatively correlated with the above inflammatory indexes (r=-0.351, -0.331, -0.301; all P＜0.001). Procalcitonin, CRP, IL-6 and miR-155 were independent risk factors for severe pneumonia in elderly patients, while miR-1323 was an independent protective factor (all P＜0.05). Single detection of miR-1323 owned high sensitivity of 98.1% with the area under curve (AUC) of 0.861, and single miR-155 detection presented high specificity of 90.5% with AUC=0.761. Combined detection of two indicators achieved optimal balance between sensitivity (73.6%) and specificity (87.1%) with the highest diagnostic efficiency (AUC=0.885). Conclusions Elevated serum miR-155 and decreased miR-1323 are prominent features of severe pneumonia in elderly individuals, and their expression imbalance is closely associated with disease severity. Combined measurement of miR-155 and miR-1323 possesses favorable diagnostic performance for elderly severe pneumonia, which can serve as a helpful supplement to conventional inflammatory markers and provide novel molecular evidence for early identification of high-risk patients in clinical practice.