结核性脑膜炎患儿外周血MiR-125b及脑脊液β2微球蛋白表达及临床意义  

Expression of MiR-125b in peripheral blood andβ2 microglobulin in cerebrospinal fluid of children with tuberculous meningitis and their clinical significance

作　　者：王静娴 刘雪琴[2] 仝桃玲 高亮 张玉玲 WANG Jing-xian;LIU Xue-qin;TONG Tao-ling;GAO Liang;ZHANG Yu-ling(Medical College of Luoyang Polytechnic,Luoyang,Henan 471000,China)

机构地区：[1]洛阳职业技术学院医学院,河南洛阳471000 [2]新乡市中心医院儿科,河南新乡453000 [3]洛阳市第三人民医院儿科,河南洛阳471000 [4]驻马店市中心医院儿科,河南驻马店463000 [5]洛阳市妇幼保健院内科,河南洛阳471000

出　　处：《中华医院感染学杂志》2021年第9期1431-1435,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划基金资助项目(LHGJ20190942)。

摘　　要：目的分析结核性脑膜炎(TBM)患儿外周血微小RNA-125b(MiR-125b)及脑脊液β2-微球蛋白(β2-MG)表达及临床意义。方法选取2015年1月-2020年1月于医院就诊的204例脑膜炎患儿为研究对象,根据感染病原体,分为TBM组106例和病毒性脑膜炎(VM)组98例。选取同期医院收治的50例非脑膜炎患儿为对照组,入组第2d,采用酶联免疫吸附法(ELISA)检测血浆和脑脊液中肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)、C-反应蛋白(CRP)、β2-MG水平,采用逆转录聚合酶链反应(RT-PCR)法检测血浆MiR-125b水平。受试者工作特征曲线(ROC)分析MiR-125b、β2-MG、炎症因子水平对TBM患儿的诊断价值。结果TBM组患儿的血TNF-α、IL-6、CRP和MiR-125b水平均高于VM组和对照组(P<0.05),VM组患儿的血TNF-α、IL-6、CRP和MiR-125b水平均高于对照组(P<0.05);TBM组患儿的脑脊液TNF-α、IL-6、CRP和β2-MG水平均高于VM组和对照组(P<0.05),VM组患儿的脑脊液TNF-α、IL-6、CRP和β2-MG水平均高于对照组(P<0.05);血浆中TNF-α、IL-6、CRP和MiR-125b诊断TBM的AUC依次为0.703、0.650、0.723和0.708,脑脊液TNF-α、IL-6、CRP、β2-MG诊断TBM的AUC依次为0.752、0.744、0.759和0.805。结论TBM患儿外周血MiR-125b、脑脊液β2-MG和炎症因子水平均显著升高,可用于TBM的诊断。OBJECTIVE To explore the expression of MiR-125 b in peripheral blood andβ2 microglobulin in cerebrospinal fluid of children with tuberculous meningitis(TBM)and analyze the clinical significance.METHODS A total of 204 children with TBM who were treated in the hospital from Jan 2015 to Jan 2020 were recruited as the study subjects and divided into the TBM group with 106 cases and the viral meningitis(VM)group with 98 cases according to the pathogens causing the infection,meanwhile,50 non-meningitis children who were treated in the hospital were chosen as the control group.The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)andβ2-MG in plasma and cerebrospinal fluid(CSF)were detected by using enzyme-linked immunosorbent assay(ELISA),the level of plasma MiR-125 b was detected by reverse transcription polymerase chain reaction(RT-PCR).The values of MiR-125 b,β2-MG and inflammatory factors in diagnosis of TBM were analyzed with the use of receiver operating characteristic(ROC)curve.RESULTS The levels of plasma TNF-α,IL-6,CRP and miR-125 b of the TBM group were significantly higher than those of the VM group and the control group P<0.05);the levels of plasma TNF-α,IL-6,CRP and miR-125 b of the VM group were significantly higher than those of the control group(P<0.05).The levels of CSF TNF-α,IL-6,CRP andβ2-MG of the TBM group were significantly higher than those of the VM group and the control group(P<0.05),and the levels of CSF TNF-α,IL-6,CRP andβ2-MG of the VM group were significantly higher than those of the control group(P<0.05).The AUCs of the plasma TNF-α,IL-6,CRP and MiR-125 b were respectively 0.703,0.650,0.723 and 0.708 in diagnosis of TBM;the AUCs of the CSF TNF-α,IL-6,CRP andβ2-MG were respectively 0.752,0.744,0.759 and 0.805 in diagnosis of TBM.CONCLUSION The levels of peripheral blood MiR-125 b,CSFβ2-MG and inflammatory factors of the children with TBM are significantly elevated,which can be used for the diagnosis of TBM.

关 键 词：患儿 结核性脑膜炎 微小RNA-125b Β2微球蛋白 

分 类 号：R529.3[医药卫生—内科学]