大疱性类天疱疮患者血清及疱液外泌体microRNA-146b-5p的表达及其临床意义  

Expression and clinical significance of microRNA-146B-5P in exosomes derived from serum and blister fluid of patients with bullous pemphigoid

作　　者：迟红梅 王静静 张仲远 张斌 Chi Hong-mei;Wang Jing-jing;Zhang Zhong-yuan;Zhang Bin(Department of Clinical Laboratory Medicine,Qingdao Hospital of Traditional Chinese Medicine,Qingdao,Shandong 266033,China)

机构地区：[1]青岛市中医医院检验科,山东青岛266033

出　　处：《中国现代医学杂志》2023年第16期72-77,共6页China Journal of Modern Medicine

基　　金：山东省自然科学基金面上项目(No:ZR202103030420)。

摘　　要：目的探讨大疱性类天疱疮(BP)患者血清及疱液外泌体microRNA-146b-5p表达的意义。方法选取2019年6月—2021年12月青岛市中医医院收治的79例BP患者作为研究组。另选取同期该院体检的61例健康群众作为对照组。收集两组基本资料、生化指标,采用实时荧光定量聚合酶链反应测定microRNA-146b-5p表达情况。采用多因素Logistic逐步回归分析影响BP诊断的因素,采用受试者工作特征(ROC)曲线分析血清外泌体microRNA-146b-5p对早期BP的诊断效能,采用Pearson分析BP患者血清及疱液外泌体microRNA-146b-5p表达与病情严重程度的相关性。结果两组性别、年龄、体质量指数≥25 kg/m^(2)、合并高血压、合并糖尿病、合并高脂血症、合并冠心病、吸烟史、饮酒史,血肌酐、血尿酸、谷丙转氨酶、谷草转氨酶、总胆红素、血红蛋白、白蛋白、白细胞计数、血小板计数、降钙素原、肿瘤坏死因子α、CD14^(+)T淋巴细胞、CD8^(+)T淋巴细胞、白细胞介素6、白细胞介素4、白细胞介素21、血清25-羟维生素D比较,差异无统计学意义(P>0.05)。研究组C反应蛋白、OX40、OX40L、巨噬细胞游走抑制因子、嗜酸性粒细胞阳离子蛋白、血清外泌体microRNA-146b-5p相对表达量均高于对照组,研究组CD4^(+)T淋巴细胞水平低于对照组。多因素Logistic逐步回归分析结果显示:血清外泌体microRNA-146b-5p相对表达量[O^R=5.191(95%CI:2.136,12.617)]、CD4^(+)T淋巴细胞水平[O^R=4.894(95%CI:2.014,11.894)]、ECP[O^R=4.076(95%CI:1.677,9.905)]是BP诊断的影响因素(P<0.05)。ROC曲线分析显示,血清外泌体microRNA-146b-5p相对表达量诊断BP的最佳截断值为1.11,敏感性为73.42%(95%CI:0.621,0.824),特异性为80.33%(95%CI:0.678,0.890),曲线下面积为0.766(95%CI:0.671,0.861)。Pearson相关性分析显示,BP患者疱液外泌体microRNA-146b-5p与BPDAI评分呈正相关(r=0.741,P<0.05),血清microRNA-146b-5p相对表达量与BPDAI评分呈正相关(rObjective To investigate the expression and clinical significance of microrNA-146B-5P in exosomes derived from serum and blister fluid of patients with bullous pemphigoid(BP).Methods Seventy-nine BP patients admitted to our hospital from June 2019 to December 2021 were selected as the study group.In addition,61 healthy people undergoing health checkup in our hospital during the same period were selected as the control group.The basic data and biochemical indicators of the two groups were collected.The expression of microrNA 146B-5p was determined by quantitative real-time polymerase chain reaction.Multivariable Logistic regression analysis was performed to determine the factors affecting the diagnosis of BP.The receiver operating characteristic(ROC)curve was used to analyze the value of serum exosomal microrNA-146B-5p in the early diagnosis of BP.Pearson method was applied to analyze the correlation between the expression of exosomal microrNA-146B-5p in serum and blister fluid of BP patients and the severity of the disease.Results There was no difference in the sex composition,age,the proportion of patients with body mass index≥25 kg/m^(2),the proportions of patients with combined hypertension,diabetes mellitus,hyperlipidemia,and coronary heart disease,the proportions of patients with a history of smoking and alcohol consumption,the levels of serum creatinine,blood uric acid,alanine aminotransferase,aspartate aminotransferase,total bilirubin,hemoglobin,and albumin,white blood cell count,platelet count,and the levels of procalcitonin,tumor necrosis factorα,CD14^(+)T cells,CD8^(+)T cells,interleukin(IL)-6,IL-4,IL-21 and 25-hydroxyvitamin D between the two groups(P>0.05).The levels of C-reactive proteins,OX40,OX40L,macrophage migration inhibitor factor,eosinophil cationic protein(ECP),and serum exosomal microRNA-146b-5p in the study group were higher than those in the control group,whereas the level of CD4^(+)T cells in the study group was lower than that in the control group.Multivariable stepwise Logistic regre

关 键 词：大疱性类天疱疮 microRNA-146b-5p 诊断 病情 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]