血miR-24表达与重症肺炎患儿病情及预后的关系  

Relationship between miR-24 expression in peripheral blood and prognosis of children with severe pneumonia

作　　者：高莉莉 唐志红[1] 周景 周琴 李赢 GAO Lili;TANG Zhihong;ZHOU Jing;ZHOU Qin;LI Ying(Department of Pediatrics,Suzhou High-tech Zone People's Hospital,Suzhou 215129,China)

机构地区：[1]苏州高新区人民医院儿科,215129

出　　处：《浙江医学》2023年第6期624-628,共5页Zhejiang Medical Journal

摘　　要：目的 探讨血miR-24表达与重症肺炎患儿病情及预后的关系。方法 选取2017年3月至2020年3月苏州高新区人民医院收治的72例重症肺炎患儿为重症组,120例普通肺炎患儿为轻症组;本院同期健康体检的150名健康儿童为对照组。采用qRT-PCR法检测3组对象外周静脉血miR-24表达水平,采用急性生理与慢性健康状况评价Ⅱ(APACHEⅡ)、序贯器官衰竭(SOFA)评分评价肺炎患儿病情,根据治疗后1周疗效(显效和有效均归为有效)评估重症肺炎患儿预后。比较3组对象血miR-24表达水平及APACHEⅡ、SOFA评分,分析重症肺炎患儿3项指标的相关性,比较重症组不同预后患儿3项指标,采用ROC曲线分析3项指标单独及联合检测对重症组患儿预后的预测效能。结果 3组对象血miR-24表达水平及APACHEⅡ、SOFA评分比较,差异均有统计学意义(均P<0.05)。重症组患儿血miR-24表达水平与APACHEⅡ、SOFA评分均呈负相关(r=-0.785、-0.315,均P<0.05)。重症组有效患儿血miR-24表达水平明显高于无效患儿(P<0.05),而APACHEⅡ、SOFA评分均明显低于无效患儿(均P<0.05)。血miR-24表达水平(OR=0.007)、APACHEⅡ评分(OR=1.171)是重症组患儿预后的影响因素(均P<0.05),联合指标的回归方程为0.495-4.930×miR-24+0.158×APACHEⅡ评分。血miR-24表达水平、APACHEⅡ评分、SOFA评分、联合指标预测重症组患儿预后的AUC分别为0.768、0.757、0.682、0.771。结论 重症肺炎患儿血miR-24表达水平降低与病情加重及预后有关,联合血miR-24与APACHEⅡ评分检测能提高预后的预测效能。Objective To explore the relationship between miR-24 expression in peripheral blood and the prognosis of children with severe pneumonia.Methods Seventy-two children with severe pneumonia admitted in Suzhou High-tech Zone People's Hospital from March 2017 to March 2020 were enrolled(severe group)in the study,120 children with common pneumonia were also enrolled as the mild group,and 150 healthy children as the control group.The expression level of miR-24 in peripheral blood of 3 groups was detected.The severity of pneumonia was evaluated by APACHEⅡscore and SOFA score.The treatment effectiveness of children with severe pneumonia 1 week after treatment was used as the index of prognosis.The correlation of miR-24 expression level with APACHEⅡ,SOFA scores and disease severity was analyzed.The effect of miR-24 level,APACHEⅡ,SOFA scores in predicting prognosis of severe pneumonia was evaluated by ROC curve.Results The expression level of miR-24 in peripheral blood and APACHEⅡand SOFA scores of the three groups were significantly different(all P<0.05).The expression of miR-24 was negatively correlated with APACHEⅡscore and SOFA score in severe group(r=-0.785,-0.315,both P<0.05).The expression level of miR-24 in treatment effective children of severe group was higher than that in ineffective children,while APACHEⅡscore and SOFA score were lower than those in ineffective children(P<0.05).The expression level of miR-24(OR=0.007)and APACHEⅡscore(OR=1.171)were influencing factors of the treatment effectiveness of children in severe group(all P<0.05).The regression equation was 0.495-4.930×miR-24+0.158×APACHEⅡscore.The area under ROC curve(AUC)of miR-24 expression level in peripheral blood,APACHEⅡscore,SOFA score and combination of three indicators in predicting the prognosis of children in severe group were 0.768,0.757,0.682 and 0.771,respectively.Conclusion The miR-24 expression is down-regulated in children with severe pneumonia,which is relates to the severity and prognosis of patients.The combination

关 键 词：重症肺炎 miR-24 病情 预后 预测 

分 类 号：R725.6[医药卫生—儿科]