新生儿急性呼吸窘迫综合征血清miR-141-3p、KEAP1表达及临床意义  

Serum miR-141-3p,KEAP1 expression and clinical significance in neonatal acute respiratory distress syndrome

作　　者：薛相丽 李程程 刘梅 唐朋伟 XUE Xiangli;LI Chengcheng;LIU Mei;TANG Pengwei(Department of Neonatology,Taihe Hospital Affiliated to Wannan Medical College,Fuyang,Anhui 236600,China)

机构地区：[1]皖南医学院附属太和医院新生儿科,安徽阜阳236600

出　　处：《国际检验医学杂志》2025年第7期801-805,811,共6页International Journal of Laboratory Medicine

基　　金：安徽省卫生健康委科研项目(AHWJ2020b0116)。

摘　　要：目的 探讨新生儿急性呼吸窘迫综合征(NARDS)血清微小RNA-141-3p(miR-141-3p)、Kelch样环氧氯丙烷相关蛋白1(KEAP1)表达及临床意义。方法 选取2022年1月至2024年3月该院收治的NARDS患儿121例(NARDS组)和同期65例健康新生儿(对照组),NARDS患儿根据病情严重程度分为轻度NARDS组(4≤氧指数<8,48例),中度NARDS组(8≤氧指数<16,46例),重度NARDS组(氧指数≥16,27例),根据28 d预后分为死亡组(18例)和存活组(103例)。采用实时荧光定量聚合酶链反应和酶联免疫吸附试验检测血清miR-141-3p、KEAP1水平。通过Pearson相关系数分析NARDS患儿血清miR-141-3p与KEAP1水平的相关性,Spearman相关系数分析NARDS患儿血清miR-141-3p、KEAP1水平与氧指数的相关性,绘制受试者工作特征曲线分析血清miR-141-3p、KEAP1水平对NARDS患儿死亡的预测效能。结果 NARDS组血清miR-141-3p水平低于对照组,KEAP1水平高于对照组(t=14.288、12.596,P<0.001)。miR-141-3p与KEAP1在3′-非翻译区131~138处存在结合位点。Pearson相关系数分析结果显示,NARDS患儿血清miR-141-3p与KEAP1水平呈负相关(r=-0.745,P<0.001)。血清miR-141-3p水平在重度NARDS组、中度NARDS组、轻度NARDS组中依次升高,KEAP1水平则依次降低(F=185.469、113.126,P<0.001)。Spearman相关系数分析结果显示,NARDS患儿氧指数与血清miR-141-3p水平呈负相关(r=-0.815,P<0.001),与血清KEAP1水平呈正相关(r=0.827,P<0.001)。死亡组血清miR-141-3p水平低于存活组,KEAP1水平高于存活组(t=4.213、4.495,P<0.001)。血清miR-141-3p、KEAP1水平联合预测NARDS患儿死亡的曲线下面积为0.878(95%CI:0.806~0.930),大于血清miR-141-3p、KEAP1水平单独预测的0.783(95%CI:0.699~0.853)、0.786(95%CI:0.702~0.855,Z=2.963、2.021,P<0.05)。结论 NARDS患儿血清miR-141-3p水平降低和KEAP1水平升高,二者与病情加重和不良预后有关,血清miR-141-3p、KEAP1水平联合对NARDS患儿死亡有较高的预测效能。Objective To investigate the expression and clinical significance of serum microRNA-141-3p(miR-141-3p) and Kelch like epichlorohydrin associated protein 1(KEAP1) in neonatal acute respiratory distress syndrome(NARDS).Methods A total of 121 children with NARDS admitted to the hospital from January 2022 to March 2024(NARDS group) and 65 healthy neonates during the same period(control group) were selected.According to the degree of disease,the children with NARDS were divided into the mild NARDS group(4≤oxygen index<8,48 cases),the moderate NARDS group(8≤oxygen index<16,46 cases),the severe NARDS group(oxygen index ≥16,27 cases),and the children with NARDS were divided into the death group(18 cases) and the survival group(103 cases) according to the 28-day prognosis.Serum miR-141-3p and KEAP1 levels were detected by fluorescence quantitative polymerase chain reaction and enzyme-linked immunosorbent assay.The correlation between serum miR-141-3p and KEAP1 levels in children with NARDS was analyzed by Pearson correlation coefficient.The correlation between serum miR-141-3p and KEAP1 levels and oxygen index in children with NARDS was analyzed by Spearman correlation coefficient.Receiver operating characteristic(ROC) curve was plotted to analyze the predictive efficacy of serum miR-141-3p and KEAP1 levels on the death in children with NARDS.Results Serum miR-141-3p level in the NARDS group was lower than that in the control group,and KEAP1 level in the NARDS group was higher than that in the control group(t=14.288,12.596,P<0.001).There was a binding site between miR-141-3p and KEAP1 at the 3′-untranslated region 131-138.Pearson correlation showed that serum miR-141-3p was negatively correlated with KEAP1 level in children with NARDS(r=-0.745,P<0.001).The levels of serum miR-141-3p increased sequentially in the severe NARDS group,moderate NARDS group,and mild NARDS group,while the level of KEAP1 decreased sequentially(F=185.469,113.126,P<0.001).Spearman correlation coefficient showed that oxygen index in children

关 键 词：新生儿急性呼吸窘迫综合征 微小RNA-141-3p Kelch样环氧氯丙烷相关蛋白1 预后 

分 类 号：R722.1[医药卫生—儿科] R446.1[医药卫生—临床医学]