目的 探讨血清微小RNA(miRNA)-106a和miRNA-20a水平与新生儿呼吸窘迫综合征(NRDS)严重程度及预后的相关性。方法 选取2021年3月至2024年4月在西安交通大学附属红会医院就诊的156例NRDS患儿为NRDS组，其中男77例，女79例，出生胎龄(33。87±2。01)周。根据NRDS患儿胸部影像检查结果将其分为轻度组(50例)、中度组(74例)和重度组(32例)。根据NRDS患儿结局将其分为预后良好组132例和预后不良组24例。另选取同期在西安交通大学附属红会医院体检的健康早产儿150例作为对照组，其中男77例，女73例，出生胎龄(34。05±1。83)周。采用定量聚合酶链式反应(qPCR)测定血清miRNA-106a和miRNA-20a水平;采用Pearson相关分析NRDS患儿血清miRNA-106a和miRNA-20a水平与新生儿急性生理评分(SNAPPE-Ⅱ)、1 min Apgar评分的相关性;采用受试者操作特征曲线(ROC)评价血清miRNA-106a和miRNA-20a水平预测NRDS患儿预后的价值。采用(检验、x2检验。结果 NRDS组患儿血清miRNA-106a和miRNA-20a水平低于对照组[(0。97±0。30)比(1。70±0。53)、(0。88±0。32)比(1。57±0。55)]，差异均有统计学意义(t=14。750、13。346，均P＜0。05)。重度组、中度组、轻度组血清miRNA-106a和miRNA-20a水平及1 min Apgar评分比较，差异均有统计学意义(均P＜0。05)。预后不良组NRDS患儿血清miRNA-106a和miRNA-20a水平低于预后良好组[(0。40±0。19)比(1。07±0。36)、(0。39±0。17)比(0。97±0。34)]，SNAPPE-Ⅱ 评分高于预后良好组[(34。25±6。50)分比(18。10±3。58)分]，差异均有统计学意义(t=13。438、12。718、11。850，均P＜0。05)。血清miRNA-106a和miRNA-20a水平与SNAPPE-Ⅱ评分呈负相关(均P＜0。05)，与1 min Apgar评分呈正相关(均P＜0。05)。miRNA-106a、miRNA-20a预测NRDS患儿预后不良的灵敏度分别为95。8％、91。7％，特异度分别为 93。2％、89。4％，曲线下面积(AUC)分别为 0。961(95％CI 0。929～0。992)、0。938(95％C/0。900～0。976)，表明这些生物标志物预测NRDS患儿预后准确度较高。miRNA-106a联合miRNA-20a的灵敏度和特异度分别为91。7％、97。7％，AUC为0。984(95％CI 0。967～1。000)，表明联合检测具有更高的预测效能。结论 血清miRNA-106a和miRNA-20a水平在NRDS患儿中降低，且其水平随NRDS患儿严重程度加重而逐渐降低，二者在预测NRDS患儿预后中具有重要价值。
Relationship of miRNA-106a and miRNA-20a with severity and prognosis of patients with neonatal respiratory distress syndrome
Objective To investigate the correlation of serum levels of microRNA(miRNA)-106a and miRNA-20a with the severity and prognosis of patients with neonatal respiratory distress syndrome(NRDS).Methods One hundred and fifty-six patients with NRDS treated at Red Cross Hospital,Xi'an Jiaotong University from March 2021 to April 2024 were selected as an NRDS group,including 77 boys and 79 girls whose gestational age was(33.87±2.01)weeks.Based on the chest imaging results,the neonates were divided into a mild group(50 cases),a moderate group(74 cases),and a severe group(32 cases).According to their outcomes,the neonates were classified into a good prognosis group(132 cases)and a poor prognosis group(24 cases).Additionally,150 healthy preterm infants,including 77 males and 73 females whose gestational age was(34.05±1.83)weeks,were selected as a control group.The serum levels of miRNA-106a and miRNA-20a were measured using quantitative real-time polymerase chain reaction(qPCR).Pearson correlation analysis was used to analyze the relationship of the serum levels of miRNA-106a and miRNA-20a with the Score for Neonatal Acute Physiology,Version Ⅱ(SNAPPE-Ⅱ)and 1-minute Apgar score in the neonates.The predictive values of serum miRNA-106a and miRNA-20a levels for the prognosis of the neonates with NRDS were assessed using the receiver operating characteristic curve(ROC).t and x2 tests were used.Results The serum levels of miRNA-106a and miRNA-20a in the NRDS group were significantly lower than those in the control group[(0.97±0.30)vs.(1.70±0.53)and(0.88±0.32)vs.(1.57±0.55)],with statistical differences(t=14.750 and 13.346;both P＜0.05).There were statistical differences in the serum levels of miRNA-106a and miRNA-20a and the 1-minute Apgar score between the severe group,the moderate group,and the mild group(all P＜0.05).Compared with those in the good prognosis group,the serum levels of miRNA-106a and miRNA-20a in the poor prognosis group were lower,and the SNAPPE-Ⅱ score was higher[(0.40±0.19)vs.(1.07±0.36),(0.39±0.17)vs.(0.97±0.34),and(34.25±6.50)vs.(18.10±3.58)],with statistical differences(t=13.438,12.718,11.850,all P＜0.05).The serum levels of miRNA-106a and miRNA-20a were negatively correlated with the SNAPPE-Ⅱ score(both P＜0.05),and positively with the 1-minute Apgar score(both P＜0.05).The sensitivity and specificity of miRNA-106a for predicting the poor prognosis in the patients with NRDS were 95.8％and 93.2％,respectively,with an area under the curve(AUC)of 0.961(95％CI 0.929-0.992);the sensitivity and specificity of miRNA-20a were 91.7％and 89.4％,respectively,with an AUC of 0.938(95％CI 0.900-0.976).The sensitivity and specificity of the combination of miRNA-106a and miRNA-20a were 91.7％and 97.7％,respectively,with an AUC of 0.984(95％CI 0.967-1.000),indicating a higher predictive efficacy.Conclusions The serum levels of miRNA-106a and miRNA-20a are significantly reduced in patients with NRDS,and decrease as the disease severity increases.Both have significant value in predicting the prognosis of patients with NRDS.
万方数据
维普
