血清miR-210与新生儿呼吸窘迫综合征严重程度和预后的关系  

The relationship between serum miR-210and the severity and prognosis of neonatal respiratory distress syndrome

作　　者：杜志云[1] 史亦男 许海娟 李书秀[2] DU Zhi-yun;SHI Yi-nan;XU Hai-juan;LI Shu-xiu(Department of Neonatology,the First Hospital of Qinhuangdao City,Hebei Province,Qinhuangdao 066000,China;Department of Pediatric ICU,the First Hospital of Qinhuangdao City,Hebei Province,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院新生儿科,河北秦皇岛066000 [2]河北省秦皇岛市第一医院儿科ICU,河北秦皇岛066000

出　　处：《河北医科大学学报》2022年第11期1277-1281,1310,共6页Journal of Hebei Medical University

基　　金：秦皇岛市科学技术研究与发展计划(202101A128)。

摘　　要：目的探讨血清微小RNA-210(mircoRNA-210,miR-210)与新生儿呼吸窘迫综合征(neonatalrespiratory distress syndrome,NRDS)严重程度和预后的关系。方法收集NRDS患儿104例,根据预后分为生存组与死亡组。所有新生儿根据首次胸部X线片结果与病情严重程度分为轻度组(Ⅰ级、Ⅱ级)与重度组(Ⅲ级、Ⅳ级)。比较死亡组与生存组患儿一般资料,轻度组与重度组血清miR-210水平与新生儿急性生理学评分围生期补充Ⅱ(perinatal supplement of acute physiological score for neonatesⅡ,SNAPPE-Ⅱ)评分。绘制ROC曲线分析血清miR-210水平对NRDS患儿死亡的预测价值。采用Spearman相关性分析NRDS发生与血清miR-210的相关性。结果根据预后分组,104例患儿中预后较好81例(77.88%),死亡23例(22.12%)。生存组miR-210水平、SNAPPE-Ⅱ评分低于死亡组(P<0.05);2组性别、胎龄、出生体重、母亲年龄、病因、剖宫产、双胎、羊水异常差异无统计学意义(P>0.05)。按照胸部X线片表现分组,104例患儿轻度患儿73例,重度患儿31例。轻度组miR-210水平、SNAPPE-Ⅱ评分低于重度组(P<0.05)。NRDS发生与血清miR-210水平呈正相关(r=0.638,P<0.001)。血清miR-210与SNAPPE-Ⅱ评分呈正相关(r=0.513,P<0.05)。血清miR-210的最佳分界值为16.71 ng/L时,曲线下面积为0.763,OR=0.846,95%CI:0.892~1.064,敏感度为82.61%,特异度为86.42%。结论血清miR-210水平升高与NRDS病情严重程度以及预后密切相关,血清miR-210水平与NRDS病情程度呈正相关性,当血清miR-210临界值为16.71 ng/L时对评估NRDS患儿预后具有较高价值。Objective To explore the relationship between serum mircoRNA-210(miR-210)and the severity and prognosis of neonatal respiratory distress syndrome(NRDS).Methods A total of 104 children with NRDS were selected and divided into survival group and death group according to the prognosis of the children.All newborns were divided into mild group(gradeⅠ,Ⅱ)and severe group(gradeⅢ,Ⅳ)according to the results of the first chest radiograph and the severity of the disease.The general data of the children in the death group and the survival group were compared,and the serum miR-210 level and the scores for neonatalacute physiology and perinatal extensionⅡ(SNAPPE-Ⅱ)of the mild group and the severe group were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the value of serum miR-210 level in predicting the death of children with NRDS.Spearman correlation was used to analyze the correlation between the occurrence of NRDS and serum miR-210.Results According to grouping by prognosis,among the 104 cases,81 cases(77.88%)had good prognosis,and 23 cases(22.12%)died.The level of miR-210 and SNAPPE-Ⅱin the survival group were lower than those in the death group(P<0.05).There was no significant difference in gender,gestational age,birth weight,maternal age,etiology,cesarean section,twin pregnancy,and abnormal amniotic fluid between two groups(P>0.05).According to the chest X-ray findings,73 of the 104 children were mild and 31 were severe.The level of miR-210 and SNAPPE-Ⅱin the mild group were lower than those in the severe group(P<0.05).The occurrence of NRDS was positively correlated with the level of serum miR-210(r=0.638,P<0.001).Serum miR-210 was positively correlated with SNAPPE-Ⅱ(r=0.513,P<0.05).When the optimal cut-off value of serum miR-210 was 16.71 ng/L,the area under the ROC curve was 0.763(OR=0.846,95%CI:0.892-1.064),the sensitivity was 82.61%,and the specificity was 86.42%.Conclusion The increase in serum miR-210 level is closely related to the severity and prognosis of NRDS,and

关 键 词：呼吸窘迫综合征 新生儿 微RNAS 预后 

分 类 号：R722.12[医药卫生—儿科]