原发免疫性血小板减少症患儿外周血lncRNA-GAS5和lncRNA-PVT1表达及意义  

Expressions and significances of lncRNA-GAS5 and lncRNA-PVT1 in peripheral blood of children with primary immune thrombocytopenia

作　　者：童琳琳 方芳 许彬 马慧平[1] TONG Lin-lin;FANG Fang;XU Bin;MA Hui-ping(Department of Pediatrics,Handan Central Hospital,Handan,Hebei 056001,China;CT/MRI Room,Handan Infectious Disease Hospital,Handan,Hebei 056005,China)

机构地区：[1]邯郸市中心医院儿科,河北邯郸056001 [2]邯郸市传染病医院CT/MRI室,河北邯郸056005

出　　处：《中华实用诊断与治疗杂志》2023年第6期614-618,共5页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河北省卫生厅科研基金项目(20191863)。

摘　　要：目的 分析原发免疫性血小板减少症(immune thrombocytopenia,ITP)患儿外周血lncRNA-GAS5、lncRNA-PVT1表达情况及其与辅助T(helper T,Th)17、调节性T(regulatory T,Treg)细胞和出血评分、疗效的关系,探讨其对ITP的诊断价值和一线治疗无效的预测价值。方法 首次诊断为ITP患儿55例为ITP组,体检健康儿童45例为对照组,采用实时荧光定量PCR法检测2组外周血lncRNA-GAS5、lncRNA-PVT1相对表达量,应用流式细胞仪检测2组外周血Th17、Treg细胞百分比;采用Pearson相关法分析ITP患儿外周血lncRNA-GAS5、lncRNA-PVT1相对表达量与Th17、Treg细胞百分比的相关性;评价ITP患儿出血评分及一线治疗反应,比较不同出血评分、一线治疗不同反应的ITP患儿外周血lncRNA-GAS5、lncRNA-PVT1相对表达量;绘制ROC曲线,评估外周血lncRNA-GAS5、lncRNA-PVT1相对表达量诊断ITP及预测ITP一线治疗无效的效能。结果 ITP组外周血lncRNA-GAS5(0.68±0.18)、lncRNA-PVT1(0.71±0.18)相对表达量及Treg细胞百分比[(4.41±0.73)%]均低于对照组[1.00±0.25、1.00±0.32、(5.62±0.84)%](P<0.05),Th17细胞百分比[(2.25±0.51)%]高于对照组[(1.61±0.36)%](t=7.093,P<0.001)。ITP患儿外周血lncRNA-GAS5、lncRNA-PVT1相对表达量与Th17细胞百分比均呈负相关(r=-0.421,P=0.003;r=-0.294,P=0.017),与Treg细胞百分比均呈正相关(r=0.384,P=0.012;r=0.371,P=0.014)。出血评分1、2、3分的ITP患儿外周血lncRNA-GAS5(0.79±0.17、0.66±0.22、0.48±0.19)、lncRNA-PVT1(0.82±0.24、0.70±0.23、0.49±0.17)相对表达量均依次降低(P<0.05),一线治疗后完全反应、反应、无效的ITP患儿外周血lncRNA-GAS5(0.77±0.19、0.62±0.13、0.47±0.09)、lncRNA-PVT1(0.81±0.12、0.63±0.19、0.54±0.17)相对表达量均依次降低(P<0.05)。外周血lncRNA-GAS5、lncRNA-PVT1相对表达量以0.761、0.851为最佳截断值,单独及联合诊断ITP的AUC分别为0.849(95%CI:0.775~0.922,P<0.001)、0.781(95%CI:0.682~0.888,P<0.001)、0.933(95%CI:0.888~0.978,P<0.001),Objective To analyze the expressions of lncRNA-GAS5 and lncRNA-PVT1 in peripheral blood and their correlations with helper T 17(Th17) cell,regulatory T(Treg) cell,bleeding score and therapeutic efficacy,and to explore the values of lncRNA-GAS5 and lncRNA-PVT1 to the diagnosis of ITP and prediction of first-line treatment failure in children with primary immune thrombocytopenia(ITP).Methods The relative expressions of lncRNA-GAS5and lncRNA-PVT1 in peripheral blood were detected by real-time fluorescence quantitative PCR,and the percentages of Th17 and Treg cells in peripheral blood were detected by flow cytometry in 55 children with initial diagnosis of ITP(ITP group) and 45 healthy volunteers(control group).The correlations of the relative expressions of lncRNA-GAS5 and lncRNA-PVT1 with the percentages of Th17 and Treg cells were analyzed by Pearson correlation method.The bleeding score and first-line treatment efficacy on ITP were evaluated,and the relative expressions of lncRNA-GAS5 and l ncRNA-PVT1 were detected in ITP children with different bleeding scores and different responses after first-line treatment.ROC curves were drawn to assess the efficiencies of lncRNA-GAS5 and lncRNA-PVTl on the diagnosis of ITP and the prediction of first-line treatment failure.Results The relative expressions of lncRNA-GAS5 and lncRNA-PVT1as well as the percentage of Treg cells were lower in ITP group [0.68±0.18,0.71±0.18,(4.41±0.73) %] than those in control group [1.00±0.25,1.00±0.32,(5.62±0.84) %](P<0.05),and the percentage of Th17 cells was higher in ITP group [(2.25±0.51)%] than that in control group [(1.61±0.36) %](t=7.093,P<0.001).In ITP group,the relative expressions of lncRNA-GAS5 and lncRNA-PVTl were negatively correlated with Th17 percentage(r=-0.421,P=0.003;r=-0.294,P=0.017),and positively correlated with Treg percentage(r=0.384,P=0.012;r=0.371,P=0.014).The relative expressions of lncRNA-GAS5(0.79±0.17,0.66±0.22,0.48±0.19)and lncRNA-PVT1(0.82±0.24,0.70±0.23,0.49±0.17) decreased sequentially in ITP chil

关 键 词：原发免疫性血小板减少症 lncRNA-GAS5 lncRNA-PVT1 辅助性T17细胞 调节性T细胞 

分 类 号：R725.5[医药卫生—儿科]