血清微小RNA-155水平评估肺炎支原体肺炎预后的价值  

Value of serum microRNA-155 level in evaluating prognosis of Mycoplasma pneumoniae pneumonia

作　　者：李敏[1] 孙晓敏[2] 赵二要 张磊[1] 董利利[1] LI Min;SUN Xiao-min;ZHAO Er-yao;ZHANG Lei;DONG Li-li(Department of Respiratory MedicineChildren’s Hospital Affiliated to Zhengzhou University,Henan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou 450000,China;Ward-1 of General Internal Medicine Department,Children’s Hospital Affiliated to Zhengzhou University,Henan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院河南省儿童医院郑州儿童医院呼吸科,河南郑州450000 [2]郑州大学附属儿童医院河南省儿童医院郑州儿童医院普内一病区,河南郑州450000

出　　处：《中国感染控制杂志》2021年第10期909-915,共7页Chinese Journal of Infection Control

基　　金：河南省医学科技攻关联合共建项目(2018020614)。

摘　　要：目的探讨微小RNA-155(miR-155)在肺炎支原体肺炎(MPP)患儿外周血中的表达意义。方法选取某院2016年12月—2019年6月收治的MPP患儿,将其分为普通MPP组和难治性MPP(RMMP)组,并根据是否发生肺外损伤将RMPP患儿分为合并肺外损伤组和未合并肺外损伤组;检测并比较不同组患儿外周血中miR-155、γ干扰素(IFN-γ)、白细胞介素-4(IL-4)水平差异。结果共有MPP患儿136例,普通MPP组80例,RMPP组56例;RMPP患儿中肺外损伤组25例,无肺外损伤组31例。RMPP组IFN-γ、IL-4、miR-155水平高于普通MPP组,IFN-γ/IL-4低于普通MPP组,差异均有统计学意义(均P<0.05);RMPP组内miR-155水平与IFN-γ/IL-4呈负相关(r=-0.307,P=0.021);miR-155诊断RMPP的受试者工作特征曲线(ROC)曲线下面积为0.742,且miR-155是RMPP的独立影响因素;与无肺外损伤组相比,肺外损伤组IL-4、miR-155水平升高,IFN-γ/IL-4降低,差异均有统计学意义(均P<0.05);肺外损伤组内miR-155水平与IFN-γ/IL-4不相关(P>0.05);miR-155诊断RMPP合并肺外损伤的ROC曲线下面积为0.724,且miR-155是RMPP合并肺外损伤的独立危险因素。结论miR-155在RMPP患儿外周血中高表达,与T淋巴细胞平衡密切相关,且对RMPP诊断及肺外损伤的早期识别具有一定的诊断价值。Objective To investigate the expression significance of microRNA-155(miR-155)in peripheral blood of children with Mycoplasma pneumoniae pneumonia(MPP).Methods Children with MPP who admitted to a hospital from December 2016 to June 2019 were selected and divided into common MPP group(CMPP group)and refractory MPP group(RMPP group),according to whether there was extrapulmonary injury,children with RMPP were divided into extrapulmonary injury group and non-extrapulmonary injury group;miR-155,interferon-γ(IFN-γ)and interleukin-4(IL-4)in peripheral blood of children in different groups were detected and compared.Results There were 136 children with MPP,80 in CMPP group and 56 in RMPP group;among children with RMPP,there were 25 cases in extrapulmonary injury group and 31 in non-extrapulmonary injury group.Levels of IFN-γ,IL-4 and miR-155 in RMPP group were higher than those in CMPP group,IFN-γ/IL-4 was lower than those in CMPP group,differences were all statistically significant(all P<0.05);miR-155 level and IFN-γ/IL-4 in RMPP group was negatively correlated(r=-0.307,P=0.021);the area under the receiver operating characteristic(ROC)curve of miR-155 for diagnosis of RMPP was 0.742,and miR-155 was an independent influencing factor for RMPP;compared with the non-extrapulmonary injury group,levels of IL-4 and miR-155 in extrapulmonary injury group increased,and IFN-γ/IL-4 decreased,differences were all statistically significant(all P<0.05);the level of miR-155 and IFN-γ/IL-4 in extrapulmonary injury group was not correlated(P>0.05);the area under the ROC curve of miR-155 for the diagnosis of RMPP complicated with extrapulmonary injury was 0.724,and miR-155 was an independent risk factor for RMPP complicated with extrapulmonary injury.Conclusion miR-155 is highly expressed in peripheral blood of children with RMPP,which is closely related to T lymphocyte balance,and has certain diagnostic value for the diagnosis of RMPP and the early identification of extrapulmonary injury.

关 键 词：难治性肺炎支原体肺炎 MIR-155 IFN-Γ/IL-4 肺外损伤 

分 类 号：R725.6[医药卫生—儿科]