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目的:分析脓毒症患者外周血淋巴细胞中微小RNA-126（miR-126）的表达与凋亡及预后的关系，探讨其可能的潜在调控机制。方法:选择2019年1月至12月在蚌埠医学院第一附属医院重症监护病房（ICU）住院治疗的30例一般感染患者和20例脓毒症患者。取外周血分离淋巴细胞，用反转录-聚合酶链反应（RT-PCR）检测miR-126和天冬氨酸特异性半胱氨酸蛋白酶3（caspase-3）的表达量，同时测定肝肾功能等实验室指标，并计算序贯器官衰竭评分（SOFA）和急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ），观察28 d预后。用Pearson法分析miR-126与caspase-3、APACHEⅡ评分的相关性；用受试者工作特征曲线（ROC）分析miR-126对预后的预测价值；同时根据miR-126预测预后的最佳截断值将患者分为两组，绘制患者28 d Kaplan-Meier生存曲线。结果:与一般感染组比较，脓毒症组患者外周血淋巴细胞中miR-126表达量显著降低〔miR-126 mRNA（2n -ΔCt）：1.239±0.134比1.599±0.110，n P<0.01〕，caspase-3表达量和APACHEⅡ评分明显升高〔caspase-3 mRNA（2n -ΔCt）：1.172±0.132比0.901±0.143，APACHEⅡ（分）：19.75±3.74比12.63±3.94，均n P<0.01〕。Pearson相关分析显示，感染患者淋巴细胞中miR-126表达量与caspase-3表达量（n r＝-0.678，n P<0.001）、APACHEⅡ评分（n r＝-0.581，n P<0.001）均呈显著负相关。ROC曲线分析显示，外周血淋巴细胞miR-126表达量预测患者预后的ROC曲线下面积（AUC）为0.823（n P1.395，31例）和低miR-126组（miR-126≤1.395，19例），Kaplan-Meier生存曲线分析显示，高miR-126组28 d累积生存率高于低miR-126组（Log-Rank：χn 2＝11.702，n P＝0.001）。n 结论:脓毒症患者外周血淋巴细胞中miR-126可能通过促进淋巴细胞凋亡增加来影响免疫状态，其表达量高低能够反映脓毒症患者严重程度及预后。“,”Objective:To analyze the relationship between the expression of microRNA-126 (miR-126) in peripheral blood lymphocytes with apoptosis and prognosis in patients with sepsis, and to explore its potential regulatory mechanism.Methods:Thirty patients with general infection and 20 patients with sepsis admitted to the department of intensive care unit (ICU) of the First Affiliated Hospital of Bengbu Medical College from January to December 2019 were enrolled. Peripheral blood was taken to separate lymphocytes, and the expressions of miR-126 and caspase-3 were detected by reverse transcription-polymerase chain reaction (RT-PCR). At the same time, the liver and kidney function and other laboratory indexes were measured, and the sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) scores were calculated. The 28-day prognosis was observed. Pearson method was used to analyze the correlation between miR-126 and caspase-3, APACHEⅡ score. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of miR-126 on prognosis; at the same time, according to the best cut-off value of miR-126 in predicting prognosis, the patients were divided into two groups, and the 28-day Kaplan-Meier survival curve was drawn.Results:The expression of miR-126 in peripheral blood lymphocytes of patients with sepsis was lower than that of patients with general infection [miR-126 mRNA (2n -ΔCt): 1.239±0.134 vs. 1.599±0.110, n P < 0.01], while the expression of caspase-3 and APACHEⅡ score were significantly increased [caspase-3 mRNA (2 n -ΔCt): 1.172±0.132 vs. 0.901±0.143, APACHEⅡ: 19.75±3.74 vs. 12.63±3.94, both n P < 0.01]. Pearson correlation analysis showed that the expression of miR-126 was negatively correlated with the expression of caspase-3 ( n r = -0.678,n P < 0.001) and APACHEⅡ score ( n r = -0.581, n P < 0.001). ROC curve analysis showed that the area under the ROC curve (AUC) for predicting the prognosis by miR-126 expression in peripheral blood lymphocytes was 0.823 ( n P 1.395, n n = 31) and low miR-126 group (miR-126 ≤ 1.395, n n = 19) according to the best cut-off value of miR-126. Kaplan-Meier survival curve analysis showed that the 28-day cumulative survival rate of high miR-126 group was higher than that of low miR-126 group (Log-Rank: χ n 2 = 11.702, n P = 0.001).n Conclusion:miR-126 in peripheral blood lymphocytes of patients with sepsis may affect immune status by promoting apoptosis of lymphocytes, and its expression level can reflect the severity and prognosis of sepsis.