病毒性心肌炎患儿血清IL-35、miR-155和SAA的表达及临床意义  

Expression and clinical significance of serum IL-35,MIR-155 and SAA in children with viral myocarditis

作　　者：张小建 张军毅[1] 冯嵩[1] 李丹[1] ZHANG Xiaojian;ZHANG Junyi;FENG Song;LI Dan(Ward 2,Department of Pediatrics,Internal Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,China,450052)

机构地区：[1]郑州大学第一附属医院小儿内科2病区,河南郑州450052

出　　处：《分子诊断与治疗杂志》2022年第6期1048-1051,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学教育研究项目(Wjlx2017438)。

摘　　要：目的分析病毒性心肌炎(VMC)患儿血清中白介素35(IL-35)、miR-155、血清淀粉样蛋白A(SAA)的表达及临床意义。方法选取2018年1月至2020年3月郑州大学第一附属医院收治的121例VMC患者,另选取本院同期116例行健康体检儿童作为对照组。比较两组血清IL-35、miR-155、SAA表达水平,比较不同病情程度患者IL-35、miR-155、SAA及心肌损伤标志物[磷酸肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)]表达情况;分析IL-35、miR-155、SAA与心肌损伤标志物相关性以及三者对VMC的预测价值。结果VMC组miR-155、SAA水平均明显高于对照组,IL-35低于对照组,差异均有统计学意义(P<0.05)。重度组miR-155、SAA、CK-MB、cTnI水平均明显高于轻度组,IL-35低于轻度组,差异均有统计学意义(P<0.05)。miR-155、SAA与CK-MB、cTnI均为正相关,IL-35与CK-MB、cTnI为负相关(P<0.05)。IL-35+miR-155+SAA联合检测对VMC预测敏感度和特异度分别为91.30%、73.90%,AUC=0.869(95%CI:0.777~0.951),明显高于三者单独预测(P<0.05)。结论IL-35、miR-155、SAA水平异常与VMC发生、发展可能存在联系,在临床中监测三者水平变化可为临床诊疗VMC提供更全面参考信息。Objective To analyze the expression and clinical significance of serum Interleukin 35(IL-35),miR-155,serum amyloid A(SAA)in children with viral myocarditis(VMC).Methods 121patients with VMC admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to March 2018 were selected,and 116 healthy children with physical examination in this hospital during the same period were selected as a control group.The expression levels of serum IL-35,MIR-155,SAA in the two groups were compared,and IL-35,miR-155,SAA and myocardial injury markers[Phosphocreatine Kinase Isoenzyme(CK MB),Cardiac troponin I(cTnI)]expression were compared.The correlation between IL-35,miR-155,SAA and myocardial injury markers,and the predictive value of the three for VMC were analyzed.Results The levels of miR-155 and SAA in the VMC group were significantly higher than those in the control group,and IL-35 was lower than that in the control group,and the differences were statistically significant(P<0.05).The levels of miR-155,SAA,CK-MB,cTnI in the severe group were significantly higher than those in the mild group,and IL-35 was lower than that in the mild group.The differences were statistically significant(P<0.05).miR-155 and SAA were positively correlated with CK-MB and cTnI,while IL-35 was negatively correlated with CK-MB and cTnI(P<0.05).The combined detection of IL-35+miR-155+SAA had a sensitivityand specificity of 91.30%and 73.90%for VMC prediction,and AUC=0.869(95%CI:0.777-0.951),which was significantly higher than that of the three alone(P<0.05).Conclusion Abnormal levels of IL-35,mi R-155,and SAA may be related to the occurrence and development of VMC.Monitoring the changes of the three levels in clinical practice can provide more comprehensive reference information for clinical diagnosis and treatment of VMC.

关 键 词：病毒性心肌炎 IL-35 MIR-155 SAA 

分 类 号：R725.4[医药卫生—儿科]