新生儿急性呼吸窘迫综合征患儿血清miR-877-5p表达变化及其与病情严重程度和预后的关系  

Expression changes of serum miR-877-5p in neonatal children with acute respiratory distress syndrome and its clinical significance

作　　者：程旺松 苏小智 陈鼎瑞 CHENG Wangsong;SU Xiaozhi;CHEN Dingrui(Department of Neonatology,Longhua District Central Hospital,Shenzhen 518110,China;不详)

机构地区：[1]深圳市龙华区中心医院广东医科大学附属龙华中心医院新生儿科,广东深圳518110 [2]河源市深河人民医院新生儿科

出　　处：《山东医药》2023年第25期5-8,共4页Shandong Medical Journal

基　　金：广东省医学科研基金立项项目(B2019055)。

摘　　要：目的探讨新生儿急性呼吸窘迫综合征(NARDS)患儿血清微小RNA-877-5p(miR-877-5p)表达变化及其临床意义。方法选择NARDS患儿95例(观察组),病情严重程度:轻度38例、中度35例、重度22例,28 d内临床结局:死亡21例、存活74例,同期选择健康新生儿40例作为对照组。采集所有研究对象外周静脉血,离心留取血清,采用实时荧光定量聚合酶链式反应检测血清miR-877-5p表达,采用酶联免疫吸附试验检测血清IL-1β、IL-6、TNF-α。采用Spearman相关分析法分析NARDS患儿血清miR-877-5p表达与氧指数和血清IL-1β、IL-6、TNF-α水平的关系。采用受试者工作特征(ROC)曲线分析血清miR-877-5p表达对NARDS诊断和预后的预测价值。结果观察组血清miR-877-5p表达低于对照组,血清IL-1β、IL-6、TNF-α水平高于对照组(P均<0.01)。随着病情严重程度增加,NARDS患儿血清miR-877-5p表达逐渐降低,血清IL-1β、IL-6、TNF-α水平逐渐升高(P均<0.01)。Spearman相关分析显示,NARDS患儿血清miR-877-5p表达与氧指数和血清IL-1β、IL-6、TNF-α水平均呈负相关关系(rs分别为-0.785、-0.779、-0.778、-0.788,P均<0.01)。NARDS患儿死亡者血清miR-877-5p表达低于其存活者(P<0.01)。ROC曲线分析显示,血清miR-877-5p表达诊断NARDS的曲线下面积为0.857(95%CI:0.787~0.911),其最佳截断值为1.23,此时其诊断NARDS的灵敏度和特异度分别为73.68%、95.00%;血清miR-877-5p表达预测NARDS死亡的曲线下面积为0.805(95%CI:0.711~0.879),其最佳截断值为0.97,此时其预测NARDS死亡的灵敏度和特异度分别为80.95%、75.68%。结论NARDS患儿血清miR-877-5p表达降低,其表达变化与病情严重程度和预后密切相关。Objective To investigate the expression changes of serum microRNA-877-5p(miR-877-5p)and its clini⁃cal significance in neonates with neonatal acute respiratory distress syndrome(NARDS).Methods Ninety-five children with NARDS(observation group)were selected,and the severity of the disease was mild(38 cases),moderate(35 cases)and severe(22 cases).The clinical outcome within 28 days was:21 cases died and 74 cases survived;meanwhile,40 healthy newborns were selected as the control group.Peripheral venous blood of all subjects was collected,serum was col⁃lected by centrifugation,and serum miR-877-5p expression was detected by real-time fluorescence quantitative polymerase chain reaction,and serum IL-1β,IL-6 and TNF-αlevels were detected by enzyme-linked immunosorbent assay.Spearman correlation analysis was used to analyze the relationships between serum miR-877-5p expression and oxygen index and serum levels of IL-1β,IL-6 and TNF-αin children with NARDS.The predictive value of serum miR-877-5p expression in the diagnosis of NARDS and death of neonates was analyzed by receiver operating characteristic(ROC)curve.Results The expression of miR-877-5p in serum of the observation group was significantly lower than that in the control group,and the levels of IL-1β,IL-6,and TNF-αin serum were significantly higher than those in the control group(all P<0.01).With the increase of the severity of NARDS,the expression of miR-877-5p in serum of NARDS neonates decreased gradually,and the levels of IL-1β,IL-6 and TNF-αincreased gradually(all P<0.01).Spearman correlation analysis showed that serum miR-877-5p expression was negatively correlated with oxygen index and serum levels of IL-1β,IL-6,and TNF-αin children with NARDS(rs=-0.785,-0.779,-0.778,and-0.788,respectively;all P<0.01).The expression of miR-877-5p in dead children with NARDS was significantly lower than that in survivors(P<0.01).ROC curve analysis showed that the area under the curve of serum miR-877-5p expression in the diagnosis of NARDS was 0.857(95%CI:0.7

关 键 词：新生儿急性呼吸窘迫综合征 微小RNA-877-5p 炎症因子 病情严重程度 预后 

分 类 号：R722.1[医药卫生—儿科]