摘要
目的 探讨肺炎支原体肺炎(MPP)患儿血清miR-21、miR-146a表达变化及其与炎症因子的相关性.方法 选取2021年8月—2022年9月包头市第八医院MPP患儿62例(MPP组)、健康体检儿童45名(正常对照组).收集所有研究对象的一般资料,并检测血清miR-21、miR-146a相对表达量和炎症因子[白细胞介素(IL)-6、IL-8、IL-1β、肿瘤坏死因子α(TNF-α)]水平.根据病情严重程度将MPP患儿分为轻症组(38例)和重症组(24例).采用Pearson相关分析评估血清miR-21、miR-146a、IL-6、IL-8、IL-1β、TNF-α之间的相关性.采用受试者工作特征(ROC)曲线评价各项指标诊断重症MPP的效能.结果 MPP组血清IL-6、IL-8、IL-1β、TNF-α水平和miR-21相对表达量均高于正常对照组(P<0.001),血清miR-146a相对表达量低于正常对照组(P<0.001).重症组血清IL-6、IL-8、IL-1β、TNF-α水平和miR-21相对表达量均高于轻症组(P<0.001),血清miR-146a相对表达量低于轻症组(P<0.001).miR-21与IL-6、IL-8、IL-1β、TNF-α之间均呈正相关(P<0.05),miR-146a与miR-21、IL-6、IL-8、IL-1β、TNF-α均呈负相关(P<0.05),IL-6、IL-8、IL-1β、TNF-α之间均呈正相关(P<0.05).miR-21、miR-146a、IL-6、IL-8、IL-1β、TNF-α单项检测诊断重症MPP的曲线下面积(AUC)分别为0.794、0.770、0.829、0.837、0.866、0.865;各项指标联合检测的AUC为0.963,敏感性和特异性分别为87.5%和97.4%.结论 MPP患儿血清miR-21和miR-146a均呈异常表达,且与炎症因子密切相关,或可作为临床判断MPP患儿病情严重程度的有效指标.
Abstract
Objective To investigate the expression changes of serum miR-21 and miR-146a in children with Mycoplasma pneumoniae pneumonia(MPP)and their correlation with inflammatory factors.Methods From August 2021 to September 2022,62 MPP children(MPP group)and 45 healthy children(healthy control group)were enrolled from Baotou Eighth Hospital.The general data of all the subjects were collected,and the relative expression levels of miR-21 and miR-146a in serum and the levels of inflammatory factors[interleukin(IL)-6,IL-8,IL-1β,tumor necrosis factor-alpha(TNF-α)]were determined.According to the severity of the disease,the MPP children were classified into mild group(38 cases)and severe group(24 cases).Pearson correlation analysis was used to evaluate the correlation between serum miR-21,miR-146a,IL-6,IL-8,IL-1β and TNF-α.Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of each index in the diagnosis of severe MPP.Results Serum levels of IL-6,IL-8,IL-1β,TNF-α and the relative expression level of miR-21 in MPP group were higher than those in healthy control group(P<0.001),and the relative expression level of miR-146a in serum was lower than that in healthy control group(P<0.001).The levels of serum IL-6,IL-8,IL-1β,TNF-α and the relative expression of miR-21 in severe group were higher than those in mild group(P<0.001),and the relative expression of serum miR-146a was lower than that in mild group(P<0.001).The miR-21 was positively correlated with IL-6,IL-8,IL-1β and TNF-α(P<0.05),while miR-146a was negatively correlated with miR-21,IL-6,IL-8,IL-1β and TNF-α(P<0.05).IL-6,IL-8,IL-1β and TNF-α were positively correlated(P<0.05).The areas under curves(AUC)of miR-21,miR-146a,IL-6,IL-8,IL-1β and TNF-α in the diagnosis of severe MPP were 0.794,0.770,0.829,0.837,0.866 and 0.865,respectively.The AUC of combined determination was 0.963,and the sensitivity and specificity were 87.5%and 97.4%,respectively.Conclusions Serum miR-21 and miR-146a are abnormally expressed in MPP children,and they are related to inflammatory factors,which may be used as effective indicators for clinical judgment of the severity of MPP children.
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