血清微小RNA-192微小RNA-221中性粒细胞与淋巴细胞比值血小板与淋巴细胞比值对重症肺炎患儿合并脓毒血症的诊断价值  

Evaluation of miR-192,miR-221,NLR and PLR in severe pneumonia with sepsis

作　　者：王建斌[1] 聂晓伟 Wang Jianbin;Nie Xiaowei(Department of Laboratory Medicine,Yanqing District Hospital,Peking University Third Hospital,Beijing 102100,China)

机构地区：[1]北京市延庆区医院、北京大学第三医院延庆医院医学检验科,北京102100

出　　处：《实用医技杂志》2023年第8期533-537,共5页Journal of Practical Medical Techniques

基　　金：北京市延庆区科协金桥工程种子资金(21013)。

摘　　要：目的探讨血清微小RNA-192(miR-192)、微小RNA-221(miR-221)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)对重症肺炎患儿合并脓毒血症的诊断价值。方法选取2020年10月至2022年3月于北京市延庆区医院就诊的重症肺炎患儿256例为研究对象,其中合并脓毒血症患儿104例(试验组),剩余152例(对照组)。分别应用SysmexXN-9100血球仪检测血常规计算出亚临床指标、应用实时荧光定量聚合酶链反应(qRT-PCR)检测血清miR-192、miR-221;比较2组miR-192、miR-221、NLR、PLR差异;利用Pearson相关分析miR-192和miR-221与NLR、PLR相关性;利用受试者工作特征(ROC)曲线评价miR-192、miR-221、NLR、PLR对重症肺炎合并脓毒血症患儿诊断价值。结果重症肺炎合并脓毒血症患儿miR-192、miR-221相对于对照组表达水平降低,而NLR、PLR水平升高(t=16.272,P<0.01;t=10.972,P<0.01;t=15.352,P<0.01;t=22.278,P<0.01)。Pearson相关性分析结果显示,重症肺炎合并脓毒血症患儿miR-192与NLR、PLR表达均呈负相关(r=-0.402,P<0.01;r=-0.432,P=0.001),miR-221与NLR、PLR表达均呈负相关(r=-0.341,P=0.002;r=-0.458,P=0.001)。miR-192、miR-221、NLR、PLR对重症肺炎合并脓毒血症患儿诊断曲线下面积(AUC)分别为0.863、0.769、0.792、0.787。联合指标诊断的AUC为0.955。结论对重症肺炎合并脓毒血症患儿血清miR-192、miR-221表达水平降低,NLR、PLR、表达水平增高,且与患儿临床症状体征相符,联合检测可以提高重症肺炎合并脓毒血症患儿诊断特异度和敏感度,便于及时救治,迅速缓解患儿症状,值得临床推广。Objective To investigate the value of serum microrna-192(miR-192),microrna-221(miR-221),neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in children with severe pneumonia complicated with sepsis.Methods From October 2020 to March 2022,256 children with severe pneumonia were selected from Yanqing District Hospital.Among them,104 children with sepsis(experimental group)and the remaining 152 children with sepsis(control group)were selected.The subclinical indexes were calculated by measuring blood routine with sysmex XN-9100,and the serum levels of miR-192 and miR-221 were detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR),and the differences of miR-192,miR-221,NLR and PLR were compared between the two groups,the correlation of miR-192,miR-221,NLR and PLR was analyzed by Person,and the diagnostic value of miR-192,miR-221,NLR and PLR in severe pneumonia with sepsis was evaluated by ROC curve.Results The expression levels of miR-192 and miR-221 in children with severe pneumonia combined with sepsis were lower than those in control group,while the expression levels of NLR and PLR were higher(t=16.272,P<0.01;t=10.972,P<0.01;t=15.352,P<0.01;t=22.278,P<0.01).Pearson correlation analysis showed that miR-192 was negatively correlated with the expression of NLR and PLR(r=-0.402,P<0.01;r=-0.432,P=0.001),and miR-221 was negatively correlated with the expression of NLR and PLR(r=-0.341,P=0.002;r=-0.458,P=0.001).The AUC of miR-192,miR-221,NLR and PLR for children with severe pneumonia combined with septicemia were 0.863,0.769,0.792 and 0.787,respectively.The AUC of combined index diagnosis was 0.955.Conclusion Through the analysis of the detection of various indicators of children with severe pneumonia combined with septicemia,the levels of miR-192 and miR-221 were decreased,while the levels of NLR,PLR and expression of miR-221 were increased,and they were in line with the children′s clinical symptoms,so the combination of the detection can improve the specificity and sens

关 键 词：循环微RNA 肺炎 脓毒症 白细胞计数 

分 类 号：R725.6[医药卫生—儿科] R446.11[医药卫生—临床医学]