Neonatal sepsis is considered as a complicated syndrome, which requires urgent intervention to avoid the unfavorable outcome. Thus, biomarkers that can either distinguish sepsis early or predict sepsis outcome are of critical need. Therefore, the aim of the current study was to investigate the clinical value of miR-187, miR-101, and miR-21 on neonatal sepsis diagnosis and prediction of prognosis. Fifty neonates with sepsis, 30 neonates with SIRS, and 20 healthy neonates were selected. Relative expression levels of the selected miRNAs were quantified by qRT-PCR. Serum CRP and PCT were analyzed. miR-101 and miR-187 expression levels were elevated in septic neonates compared with SIRS neonates and normal controls. The AUC of miR-101, miR-187, and PCT to predict sepsis diagnosis were 0.908, 789, and 0.856, respectively. miR-21 expression levels in non-survivors were significantly higher than in survivors. The AUC of miR-21, a score of neonatal acute physiology (SNAP-II), and PCT to detect the predictive mortality value were 0.793, 0.781, and 0.635, respectively. Survival analysis revealed that high miR-21 expression levels were related to low survival rates. miR-21 and SNAP II were independent risk factors for sepsis mortality, and the AUC of the two combined variables’ predictive probabilities was 0.926 and yielded a specificity of 91.2% and a sensitivity of 81.3%, which was higher than that of either miR-21 or SNAP II. miR-101 might function as a hopeful diagnostic biomarker for neonatal sepsis. Additionally, miR-21 gained attention to be a valuable predictor for sepsis prognosis especially if combined with SNAP II.

中文翻译：

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循环miR-​​101、miR-187和miR-21在新生儿败血症诊断和预后中的临床价值评价

新生儿败血症被认为是一种复杂的综合征，需要紧急干预以避免不利的结果。因此，迫切需要能够早期区分脓毒症或预测脓毒症结果的生物标志物。因此，本研究的目的是探讨miR-187、miR-101和miR-21在新生儿败血症诊断和预后预测中的临床价值。选择脓毒症新生儿 50 例，SIRS 新生儿 30 例，健康新生儿 20 例。通过 qRT-PCR 量化所选 miRNA 的相对表达水平。分析血清CRP和PCT。与 SIRS 新生儿和正常对照相比，脓毒症新生儿的 miR-101 和 miR-187 表达水平升高。miR-101、miR-187 和 PCT 预测败血症诊断的 AUC 分别为 0.908、789 和 0.856。非幸存者的 miR-21 表达水平显着高于幸存者。miR-21 的 AUC、新生儿急性生理学评分 (SNAP-II) 和检测预测死亡率的 PCT 分别为 0.793、0.781 和 0.635。生存分析显示，高 miR-21 表达水平与低生存率有关。miR-21 和 SNAP II 是脓毒症死亡率的独立危险因素，两个组合变量的预测概率的 AUC 为 0.926，特异性为 91.2%，敏感性为 81.3%，高于任一 miR- 21 或 SNAP II。miR-101 可能作为一种有希望的新生儿败血症诊断生物标志物。此外，miR-21 成为脓毒症预后的有价值预测因子，尤其是与 SNAP II 结合使用时。