血清miR-34a及miR-155在新生儿急性呼吸窘迫综合征中的表达及临床意义  

Expression and clinical significance of serum miR-34a and miR-155 in neonatal acute respiratory distress syndrome

作　　者：陈小冰[1] 张雪梅[1] 陈求凝[1] 谢邦贵[1] 卢玉朱 Chen Xiao-bing;Zhang Xue-mei;Chen Qiu-ning;Xie Bang-gui;Lu Yu-zhu(Department of Neonatology,the Third People's Hospital of Hainan Province,Sanya 572000,China)

机构地区：[1]海南省第三人民医院新生儿科,海南三亚572000

出　　处：《中国急救医学》2020年第4期334-338,共5页Chinese Journal of Critical Care Medicine

基　　金：海南省卫生计生行业科研项目(18A200166)。

摘　　要：目的 探讨血清miR-34a及miR-155在新生儿急性呼吸窘迫综合征(ARDS)中的表达及临床意义.方法 选取2017年6月至2019年6月海南省第三人民医院收治的115例新生儿ARDS患者,全部进行新生儿危重评分(NCIS评分).根据新生儿生存情况分为生存组(n=81)和死亡组(n=34),按照NCIS评分结果分为非危重组(n=64,>90分)、危重组(n=31,70~90分)和极危重组(n=20,<70分),采用实时荧光定量PCR检测各组血清miR-34a及miR-155表达水平.应用受试者工作特征曲线(ROC曲线)分析血清miR-34a、miR-155表达水平及NCIS评分预测新生儿ARDS死亡的价值,Pearson相关分析血清miR-34a、miR-155表达水平与NCIS评分的相关性.结果 死亡组血清miR-34a(1.50 ±0.64 vs.0.63 ±0.12)及miR-155(2.94±0.93 vs.1.18±0.40)表达水平均明显高于生存组(P<0.05),死亡组NCIS评分[(81.30±3.50)分vs.(88.60±4.20)分]明显低于生存组(P<0.05).极危重组血清miR-34a(1.94±0.85 vs.1.17±0.43,0.48±0.06)及miR-155(3.53±1.12 vs.2.15±0.87,0.81±0.20)表达水平均明显高于危重组和非危重组(P<0.05),极危重组NCIS评分[(68.50 ±2.40)分vs.(87.60±3.85)分,(94.30±5.10)分]明显低于危重组和非危重组(P<0.05).ROC曲线分析显示,血清miR-34a、miR-155及NCIS评分三项联合预测新生儿ARDS死亡的曲线下面积(AUC) (0.925,95%CI0.860 ~0.977)最大,其敏感度和特异度为93.8%和88.4%.Pearson相关分析显示,死亡组血清miR-34a及miR-155表达水平与NCIS评分均呈负相关(r=-0.762,P<0.01;r=-0.795,P<0.01),血清miR-34a表达水平与miR-155呈正相关(r=0.807,P<0.01).结论 血清miR-34a及miR-155表达水平与新生儿ARDS病情严重程度及预后相关,联合NCIS评分对新生儿ARDS预后预测具有一定的价值.Objective To investigate the expression and clinical significance of serum miR-34a and miR-155 in neonatal acute respiratory distress syndrome(ARDS).Methods From June 2017 to June 2019,115 cases of neonatal ARDS admitted to the Third People’s Hospital of Hainan Province were selected,and the neonatal criticality score(NCIS)was used for scoring.According to the survival status of neonatal ARDS,they were divided into survival group(n=81)and death group(n=34).According to the NCIS scores,neonatal ARDS were divided into non-critical group(n=64,>90 points),critical group(n=31,70〜90 points)and extremely critical group(n=20,<70 points).Real-time fluorescent quantitative PCR was used to detect the levels of serum miR-34 a and miR-155 in each group.Value of serum levels of miR-34 a,miR-155 and NCIS score in predicting death in neonatal ARDS was evaluated by ROC curve analysis.Pearson correlation analysis were used to analyze the correlation between the expression levels of serum miR-34a and miR-155 and NCIS score.Results The expression levels of serum miR-34a(1.50±0.64 vs.0.63±0.12)and miR-155(2.94±0.93 vs.1.18±0.40)in the death group were significantly higher than those in the survival group(P<0.05),and the NCIS score[(81.30±3.50)points vs.(88.60±4.20)points]in the death group was significantly lower than that in the survival group(P<0.05).The expression levels of serum miR-34a(1.94±0.85 vs.1.17±0.43,0.48±0.06)and miR-155(3.53±1.12 vs.2.15±0.87,0.81±0.20)in extremely critical group were significantly higher than those in critical group and non-critical group(<0.05).The NCIS score[(68.50±2.40)points vs.(87.60±3.85)points,(94.30±5.10)points]in extremely critical group were significantly lower than those in the critical group and non-critical group(P<0.05).ROC curve analysis showed that the area under the curve(0.925,95%C/0.860-0.977)of serum miR-34 a,miR-155 and NCIS score combined to predict death of neonatal ARDS was the largest,with sensitivity and specificity of 93.8%and 88.4%.The correlation analysi

关 键 词：急性呼吸窘迫综合征(ARDS) 新生儿 微小核糖核酸(miR)-34a 微小核糖核酸(miR)-155 

分 类 号：R722.12[医药卫生—儿科]