外周血miR-203a-3p、TLR4与慢性肾脏病患儿肾功能的相关性  

Correlation of peripheral blood miR-203a-3p and TLR4 with renal function in children with chronic kidney disease

作　　者：王静霞[1] 陈智红[1] 叶风芳 张唤 李春珍[1] 郭娜 董洁景[1] WANG Jingxia;CHEN Zhihong;YE Fengfang;ZHANG Huan;LI Chunzhen;GUO Na;DONG Jiejing(Department of Nephrology and Immunology,Hebei Children′s Hospital,Shijiazhuang,Hebei 050030,China)

机构地区：[1]河北省儿童医院肾脏免疫科,河北石家庄050030

出　　处：《检验医学与临床》2024年第22期3291-3295,共5页Laboratory Medicine and Clinic

基　　金：河北省医学科学研究重点课题计划项目(20180618)。

摘　　要：目的探讨慢性肾脏病(CKD)患儿外周血微小RNA(miR)-203a-3p、Toll样受体4(TLR4)水平与肾功能和发生不良心血管事件的关系。方法选取2017年2月至2021年6月该院收治的106例CKD患儿作为研究组,按是否发生不良心血管事件将研究组又分为发生组和未发生组;另选取同期该院100例健康体检儿童作为对照组。采用实时荧光定量反转录聚合酶链反应检测各组外周血miR-203a-3p、TLR4水平;采用全自动生化仪检测各组肾功能指标(尿素氮、24 h尿蛋白、24 h肌酐清除率);采用Pearson相关分析CKD患儿miR-203a-3p、TLR4水平与肾功能指标水平的相关性;采用多因素Logistic回归分析CHD患儿发生心血管不良事件的影响因素。结果研究组尿素氮、24 h尿蛋白、TLR4水平均明显高于对照组,24 h肌酐清除率及miR-203a-3p水平均明显低于对照组,差异均有统计学意义(P<0.05)。Ⅰ期45例,Ⅱ期33例,Ⅲ期14例,Ⅳ期10例,Ⅴ期4例。随着病情加重,CKD患儿miR-203a-3p水平逐渐降低,TLR4水平逐渐升高,差异均有统计学意义(P<0.05)。发生组29例,未发生组77例。发生组24 h尿蛋白、TLR4水平均高于未发生组,24 h肌酐清除率及miR-203a-3p水平均低于未发生组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,CKD患儿miR-203a-3p水平与尿素氮、24 h尿蛋白、TLR4水平均呈负相关(P<0.05),与24 h肌酐清除率呈正相关(P<0.05);TLR4水平与尿素氮、24 h尿蛋白水平均呈正相关(P<0.05),与24 h肌酐清除率呈负相关(P<0.05)。多因素Logistic回归分析结果显示,24 h肌酐清除率及miR-203a-3p、TLR4水平均为CKD患儿发生不良心血管事件的影响因素(P<0.05)。结论CKD患儿miR-203a-3p水平下调,TLR4水平上调,二者与CKD患儿肾功能指标均有一定相关性,二者均为CKD患儿发生不良心血管事件的影响因素。Objective To investigate the relationship between the levels of microRNA(miR)-203a-3p and toll-like receptor 4(TLR4)in peripheral blood and renal function and adverse cardiovascular events in children with chronic kidney disease(CKD).Methods A total of 106 children with CKD admitted to this hospital from February 2017 to June 2021 were selected as the study group.According to the occurrence of adverse cardiovascular events,the study group was further divided into occurrence group and non-occurrence group.Another 100 healthy children who underwent physical examination in the hospital during the same period were selected as the control group.The levels of miR-203a-3p and TLR4 in peripheral blood of each group were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction.The renal function indexes(urinary nitrogen,24 h urinary protein,24 h creatinine clearance rate)were detected by automatic biochemical analyzer.Pearson correlation analysis was used to analyze the correlation between miR-203a-3p,TLR4 levels and renal function indicators in CKD children.Multivariate Logistic regression was used to analyze the influencing factors of adverse cardiovascular events in children with CHD.Results The levels of urea nitrogen,24 h urine protein,and TLR4 in the study group were significantly higher than those in the control group,and the 24 h creatinine clearance rate and miR-203a-3p level were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).There were 45 cases of stage Ⅰ,33 cases of stage Ⅱ,14 cases of stage Ⅲ,10 cases of stage Ⅳ and 4 cases of stageⅤ.As the disease worsened,the level of miR-203a-3p in children with CKD gradually decreased,and the level of TLR4 gradually increased,and the differences were statistically significant(P<0.05).There were 29 cases in the occurrence group and 77 cases in the non-occurrence group.The 24 h urinary protein and TLR4 levels in the occurrence group were higher than those in the n

关 键 词：慢性肾脏病 微小RNA-203a-3p TOLL样受体4 肾功能 不良心血管事件 

分 类 号：R589[医药卫生—内分泌] R446.1[医药卫生—内科学]