肺炎支原体肺炎患儿血清microR-146a、sPD-L2与疾病严重程度及预后的关系研究  

Serum microRNA-146a,sPD-L2 in children with Mycoplasma pneumoniae pneumonia and their relationship with disease severity and prognosis

作　　者：李华风 段林林 张云 LI Huafeng;DUAN Linlin;ZHANG Yun(Department of Pediatrics,Linfen People′s Hospital,Linfen,Shanxi 041000,China)

机构地区：[1]临汾市人民医院儿科,山西临汾041000

出　　处：《国际检验医学杂志》2024年第13期1552-1557,共6页International Journal of Laboratory Medicine

基　　金：山西省卫生健康科研课题(2019084)。

摘　　要：目的 研究肺炎支原体肺炎(MPP)患儿血清微小RNA(miR)-146a、可溶性程序性死亡配体2(sPD-L2)水平,分析二者与MPP病情严重程度的关系及对预后的预测价值。方法 选取2019年2月至2021年6月临汾市人民医院收治的89例MPP患儿,根据病情严重程度分为重症组(50例)和轻症组(39例)。根据MPP患儿预后分为预后良好组(70例)和预后不良组(19例)。以同期体检的50例健康儿童为对照组。采用实时荧光定量PCR检测各组血清miR-146a水平。采用酶联免疫吸附试验检测血清sPD-L2水平。采用Pearson相关性分析MPP患儿血清miR-146a与sPD-L2水平的相关性。采用Logistic回归分析影响MPP患儿预后不良的因素。采用受试者工作特征曲线分析血清miR-146a、sPD-L2对MPP患儿预后不良的预测效能。结果 对照组、轻症组及重症组血清miR-146a水平依次降低(P<0.05),而sPD-L2水平依次升高(P<0.05)。MPP患儿血清miR-146a与sPD-L2水平呈负相关(r=-0.735,P<0.001)。预后不良组发热持续时间、胸腔积液比例、C反应蛋白、重症MPP患儿比例及血清sPD-L2水平均高于预后良好组(P<0.05),而血清miR-146a水平低于预后良好组(P<0.05)。重症MPP、血清sPD-L2是MPP患儿预后不良的独立危险因素,miR-146a是保护因素(P<0.05)。血清miR-146a、sPD-L2二者联合预测MPP患儿预后不良的曲线下面积为0.915(95%CI:0.861~0.949),高于miR-146a、sPD-L2单项指标预测的0.844(95%CI:0.801~0.886)和0.859(95%CI:0.814~0.897)(Z=4.780、4.023,均P<0.05)。结论 MPP患儿血清miR-146a水平降低,sPD-L2水平升高,二者与MPP疾病严重程度有关,且二者联合检测对MPP预后不良具有较高的预测价值。Objective To investigate the serum levels of microRNA-146a(miR-146a)and soluble programmed death ligand 2(sPD-L2)in children with Mycoplasma pneumoniae pneumonia(MPP)and to analyze their relationship with disease severity and their predictive value for prognosis.Methods A total of 89 MPP patients diagnosed and treated in Linfen People′s Hospital from February 2019 to June 2021 were included,and they were divided into severe group(50 cases)and mild group(39 cases)based on disease severity.Based on the prognosis of MMP patients,they were categorized into good prognosis group(70 cases)and poor prognosis group(19 cases).Moreover,50 healthy children who underwent physical examination at the same time were setected as the control group.Real-time fluorescence quantitative PCR was performed to assess the serum miR-146a levels in each group,while serum sPD-L2 levels were measured using the enzyme-linked immunosorbent assay.Pearson correlation analysis was conducted to evaluate the relationship between serum miR-146a and sPD-L2 levels in children with MPP.Logistic regression analysis was performed to identify factors influencing poor prognosis in children with MPP.The predictive efficacy of serum miR-146a and sPD-L2 for predicting the poor prognosis in children with MPP was assessed by receiver operating characteristic curve.Results The serum miR-146a levels decreased sequentially from the control group to the mild group and the severe group(P<0.05),while the sPD-L2 levels increased sequentially(P<0.05).Serum miR-146a was negatively correlated with sPD-L2 levels in children with MPP(r=-0.735,P<0.001).Duration of fever,proportion of pleural effusion,C-reactive protein(CRP)levels,proportion of severe MPP patients and serum sPD-L2 levels in the poor prognosis group were higher than those in the good prognosis group,while serum miR-146a level was lower than that in the good prognosis group(P<0.05).Severe MMP and serum sPD-L2 were identified as independent risk factors for poor prognosis in children with MPP(P<0.05),whereas m

关 键 词：肺炎支原体肺炎 微小RNA-146a 可溶性程序性死亡配体2 儿童 严重程度 预后 

分 类 号：R446.1[医药卫生—诊断学]