血清miR-338-3p和miR-495-3p水平在重症腺病毒肺炎患儿诊断及病情评估中的应用  

Application of serum miR-338-3p and miR-495-3p levels in the diagnosis and disease assessment of severe adenovirus pneumonia in children

作　　者：于雅彬 刘佳 王兰 李英 于欣 蔡永艳[1] 马娜[1] YU Yabin;LIU Jia;WANG Lan;LI Ying;YU Xin;CAI Yongyan;MA Na(Department of Pediatrics,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China;Department of Blood Donation Service,Cangzhou Central Blood Station,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市中心医院儿科,河北沧州061000 [2]沧州市中心血站献血服务部,河北沧州061000

出　　处：《国际检验医学杂志》2024年第11期1322-1326,共5页International Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题计划(20232109)。

摘　　要：目的探讨血清微小RNA(miR)-338-3p和miR-495-3p水平在重症腺病毒肺炎患儿诊断及病情评估中的应用。方法选取2020年11月至2022年11月在沧州市中心医院接受治疗的腺病毒肺炎患儿130例作为观察组,根据患儿疾病的严重程度分为轻症肺炎组(n=90)和重症肺炎组(n=40),选取同期在沧州市中心医院检查的130例健康儿童为对照组,比较观察组和对照组、不同病情严重程度患儿血清miR-338-3p和miR-495-3p水平。采用受试者工作特征(ROC)曲线分析血清miR-338-3p和miR-495-3p对重症腺病毒肺炎的诊断价值。采用多因素Logistic回归分析重症腺病毒肺炎的影响因素。结果观察组患儿血清miR-338-3p水平比对照组低,miR-495-3p水平比对照组高(P<0.05)。轻症组和重症组电解质紊乱、循环系统并发症发生率及miR-338-3p水平、miR-495-3p水平、序贯器官衰竭评分和Murray肺损伤评分比较,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,血清miR-338-3p、miR-495-3p辅助诊断重症腺病毒肺炎的曲线下面积(AUC)分别是0.745(95%CI 0.662~0.828)、0.774(95%CI 0.685~0.863),二者联合诊断的AUC为0.884(95%CI 0.821~0.946),均优于各项指标单独检测(Z=2.593、1.963,P<0.05)。多因素Logistic回归分析结果显示,miR-495-3p是影响重症腺病毒肺炎发生的危险因素,miR-338-3p为保护因素(P<0.05)。结论重症腺病毒肺炎患儿血清miR-338-3p水平降低,miR-495-3p水平升高,且二者联合检测对重症腺病毒肺炎有一定的诊断价值,可作为评估重症腺病毒肺炎病情严重程度的血清指标。Objective To study the application of serum microRNA(miR)-338-3p and miR-495-3p levels in the diagnosis and disease evaluation of severe adenovirus pneumonia in children.Methods A total of 130 children with adenovirus pneumonia who were treated in Cangzhou Central Hospital from November 2020 to November 2022 were enrolled as an observation group.According to the severity of the disease,the children were divided into a mild pneumonia group with 90 children and a severe pneumonia group with 40 children.A total of 130 healthy children who were examined in Cangzhou Central Hospital during the same period were enrolled as the control group.The observation and control groups and the children with different disease severity were compared in terms of the serum levels of miR-338-3p and miR-495-3p.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum miR-338-3p and miR-495-3p for severe adenovirus pneumonia.Multivariate Logistic regression was used to analyze the influencing factors of severe adenovirus pneumonia.Results The observation group had a significantly lower serum level of miR-338-3p and a significantly higher serum level of miR-495-3p than the control group(P<0.05).There were significant differences in electrolyte disturbance,circulatory system complications incidence,miR-338-3p level,miR-495-3p level,sequential organ failure score and Murray lung injury score between the mild pneumonia group and the severe pneumonia group(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum miR-338-3p and miR-495-3p in the auxiliary diagnosis of severe adenovirus pneumonia were 0.745(95%CI 0.662—0.828)and 0.774(95%CI 0.685—0.863),respectively.And the AUC of the combination of the two was 0.884(95%CI 0.821—0.946),which was better than that of each index alone(Z=2.593,1.963,P<0.05).Conclusion The level of serum miR-338-3p is decreased and the level of serum miR-495-3p is increased in children with severe adenovirus pneumonia.The combined detection of miR-338-3p

关 键 词：重症腺病毒肺炎 微小RNA-338-3p 微小RNA-495-3p 

分 类 号：R725.6[医药卫生—儿科]