急性呼吸窘迫综合征患儿血清miR-34b-5p水平变化及其与炎症因子和预后的关系  

Changes of serum miR-34b-5p level in children with acute respiratory distress syndrome and its relationships with inflammatory factors and prognosis

作　　者：徐春艳 谢菲[1] 赵洁 陈瑞东 昝春香 田文秋 伊文霞[1] 岳彬[1] XU Chunyan;XIE Fei;ZHAO Jie;CHEN Ruidong;ZAN Chunxiang;TIAN Wenqiu;YI Wenxia;YUE bin(Department of Pediatrics,Cangzhou Central Hospital,Cangzhou 061000,China;不详)

机构地区：[1]沧州市中心医院儿科,河北沧州061000 [2]沧州市中心医院儿保科

出　　处：《山东医药》2022年第13期34-39,共6页Shandong Medical Journal

基　　金：河北省医学科学研究课题计划(20211650)。

摘　　要：目的探讨急性呼吸窘迫综合征(ARDS)患儿血清微小RNA-34b-5p(miR-34b-5p)水平变化及其与炎症因子和预后的关系。方法选择ARDS患儿106例(观察组),根据氧指数分为重度24例、中度42例、轻度40例,规范治疗28 d,死亡21例、存活85例。同期另选体检健康儿童63例作为对照组。采集两组清晨空腹外周静脉血,离心留取血清,采用RT-qPCR法检测血清miR-34b-5p,采用ELISA法检测血清IL-6、IL-17、TNF-α。比较两组血清miR-34b-5p、IL-6、IL-17、TNF-α水平以及不同病情ARDS患儿血清miR-34b-5p、IL-6、IL-17、TNF-α水平,并分析ARDS患儿血清miR-34b-5p水平与血清IL-6、IL-17、TNF-α水平的关系。收集ARDS患儿一般临床资料(性别、年龄、体质量、病因、PICU时间)、疾病相关资料[入院时急性生理学和慢性健康状况评估Ⅱ(APACHEⅡ)评分、首次机械通气时氧指数]、治疗相关资料(机械通气时间、是否吸入一氧化氮、是否使用神经肌肉阻滞剂、是否使用血管活性药物)以及实验室检查资料(血清miR-34b-5p、IL-6、IL-17、TNF-α水平),比较不同预后ARDS患儿一般临床资料、疾病相关资料、治疗相关资料以及实验室检查资料,将有统计学差异的资料纳入多因素Logistic回归模型,分析ARDS患儿预后不良的影响因素。采用受试者工作特征(ROC)曲线分析血清miR-34b-5p水平对ARDS患儿预后不良的预测价值。结果观察组血清miR-34b-5p水平明显低于对照组,血清IL-6、IL-17、TNF-α水平明显高于对照组(P均<0.05)。随着病情加重,ARDS患儿血清miR-34b-5p水平逐渐降低,血清IL-6、IL-17、TNF-α水平逐渐升高(P均<0.05)。ARDS患儿血清miR-34b-5p水平与血清IL-6、IL-17、TNF-α水平均呈负相关关系(P均<0.05)。单因素分析发现,机械通气时间、APACHEⅡ评分、氧指数、IL-6、IL-17、TNF-α、miR-34b-5p可能与ARDS患儿预后不良有关(P均<0.05)。多因素Logistic回归分析显示,机械通气时间、APACHEⅡ�Objective To investigate the changes of serum microRNA-34b-5p(miR--34b-5p)in children with acute respiratory distress syndrome(ARDS)and its relationships with inflammatory factors and prognosis.Methods Totally 106 children with ARDS(observation group)were selected.According to the oxygen index,they were divided into 24 cases of severe ARDS,42 cases of moderate ARDS,and 40 cases of mild ARDS.After 28 days of standard treatment,21 cases died and 85 cases survived.In the same period,63 healthy children were selected as the control group.The fasting peripheral venous blood of the two groups in the morning was collected,and the serum was centrifuged.The serum miR-34b-5p was detected by RT-qPCR,and the serum IL-6,IL-17 and TNF-α were detected by ELISA.The serum levels of miR-34b-5p,IL-6,IL-17,and TNF-α were compared between the two groups,and the levels of serum miR-34b-5p,IL-6,IL-17,and TNF-α in children with ARDS in different conditions were compared,and the relationships between serum miR-34b-5p level and serum IL-6,IL-17 and TNF-α levels in children with ARDS were also analyzed.The general clinical data(gender,age,body mass,etiology,PICU time),disease-related data[acute physiology and chronic health assessment Ⅱ(APACHEⅡ)score at admission,oxygen index at the first mechanical ventilation],treatment-related data[duration of mechanical ventilation,inhaling nitric oxide or not,whether neuromuscular blocking agents were used,and whether vasoactive drugs were used],and laboratory examination data(serum miR-34b-5p,IL-6,IL-17,TNF-α levels)of children with ARDS were collected.The general clinical data,disease-related data,treatment-related data and laboratory examination data of ARDS children with different prognosis were compared.The statistically different data were included in the multivariate Logistic regression model to analyze the influencing factors for poor prognosis of children with ARDS.The predictive value of serum miR-34b-5p level on the poor prognosis of children with ARDS was analyzed by receiver oper

关 键 词：急性呼吸窘迫综合征 微小RNA-34b-5p 炎症因子 预后 儿童 

分 类 号：R725.6[医药卫生—儿科]