miR-141与miR-146a对类风湿关节炎患者治疗效果的预测价值及其临床意义分析  

Predictive value and clinical significance of miR-141 and miR-146a in the treatment of patients with rheumatoid arthritis

作　　者：鲁惠[1] 曹贤[1] 任水明[2] LU Hui;CAO Xian;REN Shuiming(Department of Laboratory Medicine,Erdos Central Hospital,Inner Mongolia Autonomous Region,Erdos 017000,Inner Mongolia,China;Department of Rheumatology and Immunology,Erdos Central Hospital,Inner Mongolia Autonomous Region,Erdos 017000,Inner Mongolia,China)

机构地区：[1]鄂尔多斯市中心医院检验科,内蒙古鄂尔多斯017000 [2]鄂尔多斯市中心医院风湿免疫科,内蒙古鄂尔多斯017000

出　　处：《西部医学》2025年第3期447-451,共5页Medical Journal of West China

基　　金：2022年度内蒙古自治区卫生健康科技计划项目(202201580)。

摘　　要：目的探讨微小核糖核酸-141(miR-141)、微小核糖核酸-146a(miR-146a)在类风湿关节炎(RA)患者中的表达水平及临床意义。方法选取2020年10月—2022年10月鄂尔多斯市中心医院收治的RA患者176例纳入观察组,根据不同临床分期分为活动期[28个关节疾病活动度(DAS28)评分>3.2分]104例和缓解期(DAS28评分≤3.2分)72例,随访3个月观察治疗效果,以治疗3个月后DAS28评分≤2.6分为达到临床缓解,根据治疗结果将患者分为达到临床缓解组115例,未达到临床缓解组61例;另择同期182例健康体检者作为对照组,回顾性收集研究对象的临床资料。比较两组miR-141、miR-146a表达水平、实验室指标及炎症因子水平;比较不同临床分期、治疗效果RA患者miR-141、miR-146a表达水平、实验室指标及炎症因子水平,通过Pearson相关分析法分析实验室指标、炎症因子与miR-141、miR-146a表达水平的相关性。绘制受试者工作特征(ROC)曲线分析miR-141、miR-146a单独及联合检测对治疗效果的预测价值。结果观察组外周血miR-141、miR-146a表达水平高于对照组,全血血沉(ESR)、血清类风湿因子(RF)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C-反应蛋白(CRP)水平高于对照组(P<0.05)。相较缓解期,活动期外周血miR-141、miR-146a表达水平更高,DAS28评分、全血ESR、血清RF、TNF-α、IL-6、CRP水平更高(P<0.05)。相较临床缓解患者,未达到临床缓解患者外周血miR-141、miR-146a表达水平更高,DAS28评分、全血ESR、血清RF、TNF-α、IL-6、CRP水平更高(P<0.05)。Pearson相关分析法结果显示,DAS28评分、ESR、RF、TNF-α、IL-6、CRP和miR-141、miR-146a呈正相关(P<0.05)。绘制ROC曲线分析miR-141、miR-146a单独及联合检测对治疗结果的预测价值,联合检测均为最高,曲线下面积(AUC)为0.890,敏感性为83.61%,特异性为86.96%。结论RA患者miR-141、miR-146a表达更高,其升高与病情严重程度及治疗效果密切相关,Objective To analyze the predictive value of micrornA-141(miR-141),micrornA-146a(miR-146a)in the treatment of patients with rheumatoid arthritis.Methods A total of 176 patients with rheumatoid arthritis admitted to Erdos Central Hospital from October 2020 to October 2022 were included in the study group.According to different clinical analysis,the patients were divided into the active stage[28 joint disease activity(DAS28)score>3.2 points 104 cases]and the remission stage(DAS 28 score≤3.2 points)72 cases.Patients were followed up for 3 months to observe the therapeutic effect.After 3 months of treatment,patients with DAS28 score≤2.6 were classified as achieving clinical remission.According to the treatment results,patients were divided into the clinical remission(115 cases)and the clinical remission(61 cases),and 182 healthy subjects were selected as the control group during the same period.Clinical data of the subjects were retrospectively collected.The expression levels,laboratory indexes and inflammatory factors of miR-141 and miR-146a were compared between the two groups.The expression levels,laboratory indexes and inflammatory factors of miR-141 and miR-146a were compared between the active and remitting rheumatoid arthritis patients.The expression levels of miR-141 and miR-146a,laboratory indexes and inflammatory factors were compared in patients with and without clinical remission of rheumatoid arthritis.The Pearson correlation analysis was used to analyze the correlation between laboratory indicators,inflammatory factor and the expression levels of miR-141,miR-146a.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of miR-141,miR-146a alone and in combination.Results The peripheral blood levels of miR-141 and miR-146a in the study group were higher than those of the control group,whole blood levels of sediment and serum level of rheumatoid factor(RF),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)were higher than those of the control grou

关 键 词：类风湿关节炎 微小核糖核酸-141 微小核糖核酸-146a 相关性 预测价值 

分 类 号：R593.22[医药卫生—内科学]