miR-451a在肺结核患者血清中的表达水平及临床意义  

The expression level and clinical significance of serum miR-451a in patients with pulmonary tuberculosis

作　　者：赵勇 梁丽丽[2] 江南[3] ZHAO Yong;LIANG Li-li;JIANG Nan(Department of Tuberculosis,Shangqiu Chest Hospital,Shangqiu 476005,China;不详)

机构地区：[1]商丘市胸科医院结核科,河南商丘476005 [2]河南省胸科医院结核内科,河南郑州450008 [3]河南省胸科医院结核外科,河南郑州450008

出　　处：《广东医学》2024年第2期213-219,共7页Guangdong Medical Journal

基　　金：河南省医学科技攻关计划项目(SB201903027)。

摘　　要：目的 探讨活动性肺结核(ATB)患者血清微小RNA(miR)-451a、Toll样受体4(TLR4)表达水平与其预后的关系。方法 将350例肺结核患者根据诊断情况分为ATB组(162例)与非ATB组(NATB组,188例),另选180例健康体检者纳入对照组。ATB组依据预后分为预后良好组(120例)与预后不良组(42例)。检测血清miR-451a、TLR4 mRNA水平,分析ATB患者预后影响因素,Pearson法分析miR-451a与TLR4 mRNA相关性;绘制受试者工作特征(ROC)曲线分析血清miR-451a、TLR4 mRNA预测ATB患者预后的效能。结果 对照组、NATB组、ATB组血清miR-451a水平依次降低、TLR4 mRNA水平依次升高(均P<0.05)。ATB组血清miR-451a与TLR4 mRNA水平呈负相关(r=-0.519,P<0.05),血清miR-451a与C反应蛋白(CRP)、红细胞沉降率(ESR)、干扰素-γ(IFN-γ)、白细胞介素-12(IL-12)呈负相关(r=-0.404、-0.377、-0.435、-0.391,P<0.05),血清TLR4 mRNA与CRP、ESR、IFN-γ、IL-12呈正相关(r=0.469、0.361、0.442、0.384,P<0.05)。预后不良组血清miR-451a水平低于预后良好组,血清TLR4 mRNA水平高于预后良好组(P<0.05)。回归分析显示,TLR4 mRNA、miR-451a是ATB患者预后影响因素(P=0.001、0.009)。血清miR-451a联合TLR4 mRNA预测ATB患者预后不良的ROC曲线下面积(AUC)为0.949,优于单独检测miR-451a、TLR4 mRNA的0.852、0.821(P<0.05)。结论 ATB患者血清miR-451a水平降低、TLR4 mRNA水平升高,与炎症反应及预后密切相关,miR-451联合TLR4 mRNA对预后预测价值较高。Objective To investigate the correlations of serum microRNA(miR)-45la and Toll-like receptor 4(TLR4)expression levels with the prognosis of patients with active pulmonary tuberculosis(ATB).Methods sAtotal of 350 patients with pulmonary tuberculosis were classified based on their diagnostic status into ATB group(162 cases)and non-ATB(NATB)group(188 cases).Additionally,180 healthy individuals undergoing physical examinations were included as the control group.The ATB group was further divided into favorable prognosis group(120 cases)and unfavor-able prognosis group(42 cases)based on their prognosis.Serum levels of miR-45la and TLR4 mRNA were measured,and factors influencing the prognosis of ATB patients were analyzed.The Pearson method was used to analyze the correla-tion between miR-45la and TLR4 mRNA.Receiver operating characteristic(ROC)curves were drawn to assess the pre-dictive efficacy of serum miR-45la and TLR4 mRNA for the prognosis of ATB patients.Results The serum levels of miR-45la in the control group,NATB group,and ATB group decreased successively,while TLR4 mRNA levels in-creased(all P<0.05).There was a negative correlation between serum miR-45la and TLR4 mRNA levels in ATB patients(r=-0.519,P<0.05).Serum miR-451a was negatively correlated with C-reactive protein(CRP),erythro-cyte sedimentation rate(ESR),interferon-γ(IFN-γ),and interleukin-12(IL-12)(r=-0.404,-0.377,-0.435,-0.391,P<0.05),while serum TLR4 mRNA was positively correlated with CRP,ESR,IFN-γ,and IL-12(r=0.469,0.361,0.442,0.384,P<0.05).The serum miR-451a level were lower in the unfavorable prognosis group than that in the favorable prognosis group,while serum TLR4 mRNA level were higher in the unfavorable prognosis group(P<0.05).Regression analysis showed that TLR4 mRNA and miR-45la were factors influencing the prognosis of ATB patients(P=0.001,0.009).The combined predictive efficacy of serum miR-451a and TLR4 mRNA for unfavor-able prognosis in ATB patients was AUC=0.949,which was superior to the individual detection of miR-45la(AUC=0.852

关 键 词：活动性肺结核 微小RNA-451a TOLL样受体4 预后 

分 类 号：R521[医药卫生—内科学] R825.2[医药卫生—临床医学]