MicroRNA-30a、microRNA-181a在原发免疫性血小板减少症中的表达及其临床意义  

Expression and clinical significance of microRNA-30a and microRNA-181a in immune thrombocytopenic purpura

作　　者：谭琳[1] 谢瑜[1] 杨坚 黄颖[1] Lin Tan;Yu Xie;Jian Yang;Yin Huang(Department of Hematology,First Affiliated Hospital of Kunming Medical University,Yunnan,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院血液科,云南昆明650032

出　　处：《中国现代医学杂志》2021年第24期63-68,共6页China Journal of Modern Medicine

基　　金：云南省基础研究计划(昆医联合专项)(No:2018FE001-033)。

摘　　要：目的检测原发免疫性血小板减少症(ITP)患者外周血单个核细胞(PBMC)microRNA-30a(miR-30a)、microRNA-181a(miR-181a)的表达,并分析其临床意义。方法选取2020年1月—2020年12月昆明医科大学第一附属医院收治的ITP患者48例作为ITP组,另取同期该院40例化疗后骨髓抑制血小板减少患者作为对照组,体检健康者45例作为健康组。检测3组血小板计数(PLT)、平均血小板体积(MPV),采用实时荧光定量聚合酶链反应检测PBMC中miR-30a、miR-181a的表达,分析miR-30a、miR-181a与血小板参数的相关性,以及对ITP的诊断价值。结果ITP组miR-30a、miR-181a相对表达量高于对照组和健康组(P<0.05);ITP组PLT、MPV低于对照组和健康组(P<0.05)。miR-30a与PLT、MPV呈负相关(r=-0.278和-0.247,P<0.05),与出血分级呈正相关(r=0.221,P<0.05);miR-181a与PLT、MPV呈负相关(r=-0.224和-0.301,P<0.05),与出血分级呈正相关(r=0.236,P<0.05)。miR-30a[O^R=1.876(95%CI:1.230,6.336)]和miR-181a[O^R=2.665(95%CI:1.365,8.558)]升高是发生ITP的独立危险因素(P<0.05)。以miR-30a、miR-181a及其回归系数建立临床模型的多元回归方程Logistic(P)=-4.115+1.305×MPV-1.258×miR-30a-1.664×miR-181a。该临床模型诊断ITP的标准误为0.055,AUC为0.889(95%CI:0.662,0.956),敏感性为75.25%(95%CI:1.123,2.084)、特异性为88.24%(95%CI:1.672,2.583)。结论miR-30a、miR-181a与ITP发生相关,通过miR-30a、miR-181a建立个体化临床模型可准确判断ITP的发生,且具有较高的临床实用价值。Objective To detect the expression of microRNA-30 a and microRNA-181 a in peripheral blood mononuclear cells(PBMC)in patients with immune thrombocytopenic purpura(ITP)and to analyze their clinical significance.Methods A total of 48 patients with ITP admitted to our hospital from January 2020 to December2020 were selected as ITP group,40 patients with myelosuppression and thrombocytopenia after chemotherapy were selected as control group,and 45 healthy individuals undergoing physical examination were selected as health group.The platelet count(PLT)and mean platelet volume(MPV)of the three groups were tested.The expression levels of microRNA-30 a and microRNA-181 a in PBMC were detected by quantitative real-time polymerase chain reaction,and the correlation between the levels of microRNA-30 a and microRNA-181 a and the platelet parameters was analyzed.In addition,the diagnostic value of microRNA-30 a and microRNA-181 a for ITP was determined.Results The relative expression of microRNA-30 a and microRNA-181 a in the ITP group was higher than that of the control group and the health group(P<0.05),while PLT and MPV in the ITP group were lower than those in the control group and the health group(P<0.05).The relative expression of microRNA-30 a was negatively correlated with PLT and MPV(r=-0.278 and-0.247,both P<0.05),and positively correlated with bleeding grade(r=0.221,P<0.05).The relative expression of microRNA-181 a was negatively correlated with PLT and MPV(r=-0.224 and-0.301,both P<0.05),and positively correlated with bleeding grade(r=0.236,P<0.05).The increased relative expression of microRNA-30 a[O^R=1.876(95%CI:1.230,6.336)]and that of microRNA-181 a[O^R=2.665(95%CI:1.365,8.558)]were independent risk factors for ITP.The multiple regression equation of the prediction model based on the relative expression levels of microRNA-30 a and microRNA-181 a was established as Logistic(P)=-4.115+1.305×MPV-1.258×microRNA-30 a-1.664×microRNA-181 a.The standard error of the clinical model for diagnosing ITP was 0.055,the a

关 键 词：原发免疫性血小板减少症 microRNA-30a microRNA-181a 临床模型 预测 

分 类 号：R558.2[医药卫生—血液循环系统疾病]