摘要
目的 探讨急性呼吸窘迫综合征(ARDS)患儿血清长链非编码RNA OIP5-AS1(LncRNA OIP5-AS1)、微小RNA-218-5p(miR-218-5p)表达情况及二者在临床预后预测中的价值.方法 回顾性选择2020年7月至2022年2月秦皇岛市第一医院收治的104例ARDS患儿为ARDS组.根据氧合指数(PaO2/FiO2)将ARDS患儿分为重度亚组(PaO2/FiO2≤100 mmHg,n=32)、中度亚组(100 mmHg＜PaO2/FiO2 ≤ 200 mmHg,n=38)、轻度亚组(200 mmHg＜PaO2/FiO2 ≤300 mmHg,n=34).根据ARDS患儿28 d院内死亡情况将其分为存活亚组(n=74)和死亡亚组(n=30).另选择同期于本院进行健康体检的98例儿童作为对照组.比较各组血清LncRNA OIP5-AS1、miR-218-5p表达水平;收集患儿性别、年龄、气道峰值压、通气时间、入住ICU时间、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、入院急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分、入院序贯器官功能衰竭评分(SOFA)、平均气道压、潮气量、白蛋白等资料.采用Pearson相关分析ARDS死亡患儿中血清LncRNA OIP5-AS1与miR-218-5p表达水平的相关性;绘制受试者工作特征(ROC)曲线分析血清LncRNA OIP5-AS1、miR-218-5p表达水平对ARDS患儿预后的预测价值;采用Logistic回归分析影响ARDS患儿死亡的因素.结果 ARDS组血清LncRNA OIP5-AS1为2.04± 0.38,显著高于对照组(1.01±0.21),miR-218-5p为0.45±0.16,显著低于对照组(1.02±0.20),差异均有统计学意义(P＜0.05).对照组、轻度亚组、中度亚组、重度亚组ARDS患儿血清LncRNA OIP5-AS1表达水平依次升高,miR-218-5p表达水平依次降低,差异均有统计学意义(P＜0.05).死亡亚组血清LncRNA OIP5-AS1表达水平及入院A-PACHE Ⅱ评分、入院SOFA、平均气道压、潮气量均高于存活亚组,miR-218-5p表达水平及PaO2、白蛋白均低于存活亚组,差异均有统计学意义(P＜0.05).ARDS死亡患儿中血清LncRNA OIP5-AS1与miR-218-5p表达水平呈负相关(r=-0.503,P＜0.05).血清LncRNA OIP5-AS1、miR-218-5p及二者联合预测ARDS患儿死亡的曲线下面积分别为 0.852、0.812、0.904.LncRNA OIP5-AS1 是 ARDS 患儿死亡的独立危险因素(P＜0.05),miR-218-5p 是 ARDS患儿死亡的保护因素(P＜0.05).结论 ARDS患儿血清LncRNA OIP5-AS1＞2.04,miR-218-5p＜0.39,均与病情严重程度及预后不良有关.
Abstract
Objective To investigate the expression of serum long non-coding RNA OIP5-AS1(LncRNA OIP5-AS1)and microRNA-218-5p(miR-218-5p)in children with acute respiratory distress syndrome(ARDS)and their value in clinical prognosis prediction.Methods A total of 104 children with ARDS admitted to the First Hospital of Qinhuangdao from July 2020 to February 2022 were retrospectively selected as the ARDS group.According to the oxygenation index(PaO2/FiO2),children with RDS were divided into the severe subgroups(PaO2/FiO2≤100 mmHg,n=32),the moderate subgroups(100 mmHg＜PaO2/FiO2 ≤200 mmHg,n=38),and the mild subgroups(200 mmHg＜PaO2/FiO2 ≤300 mmHg,n=34).According to the in-hospital mortality rate of ARDS patients at 28 days,they were divided into the survival subgroup(n=74)and the death subgroup(n=30).Another 98 children who underwent health examinations in our hospital during the same period were selected as the control group.The expression levels of serum LncRNA OIP5-AS1 and miR-218-5p in each group were com-pared.The gender,age,peak airway pressure,ventilation time,ICU admission time,arterial carbon dioxide pressure(PaCO2),arterial oxygen pressure(PaO2),admission acute physiology and chronic health status evaluation Ⅱ(APACHE Ⅱ)score,admission sequential organ failure score(SOFA),mean airway pressure,tidal volume,albumin,and other data of the patient were collected.The correlation between serum Ln-cRNA OIP5-AS1 and miR-218-5p expression levels in children with ARDS death were analyzed by Pearson correlation.The predictive value of serum LncRNA OIP5-AS1 and miR-218-5p expression levels on the prognosis of children with ARDS were analyzed by drawning receiver operating characteristic(ROC)curve;and the factors affecting the death of children with ARDS were analyzed by Logistic regression.Results The serum LncRNA OIP5-AS1 in the ARDS group was 2.04±0.38,which was significantly higher than that in the control group(1.01±0.21),the miR-218-5p in the ARDS group was 0.45±0.16,which was significantly lower than that in the control group(1.02±0.20),the differ-ence were statistically significant(P＜0.05).The expression level of serum LncRNA OIP5-AS1 in control group,mild subgroup,moderate subgroup and severe subgroup of ARDS children increased in turn,and the expression level of miR-218-5p decreased in turn,the differences were statistically significant(P＜0.05).The expression level of serum LncRNA OIP5-AS1,the APACHEⅡ score,SOFA score,mean airway pressure and tidal volume in the death subgroup were higher than those in the survival subgroup,and the expression level of miR-218-5 p,PaO2 and albumin were lower than those in the survival subgroup,the differences were statistically significant(P＜0.05).The expression levels of ser-um LncRNA OIP5-AS1 and miR-218-5p were negatively correlated in children with ARDS death(r=-0.503,P＜0.05).The areas un-der the curve(AUC)of serum LncRNA OIP5-AS1,miR-218-5p and their combination in predicting death in children with ARDS were 0.852,0.812,and 0.904,respectively.LncRNA OIP5-AS1 was an independent risk factor for death in children with ARDS(P＜0.05),and miR-218-5p was a protective factor for death in children with ARDS(P＜0.05).Conclusion LncRNA OIP5-AS1＞2.04,miR-218-5p＜0.39,are decreased in children with ARDS,which are related to the severity of the disease and poor prognosis.
基金项目
河北省医学科学研究课题计划(20190849)
秦皇岛市科学技术研究与发展计划(202101A128)
NETL
NSTL
维普
万方数据