Predictive value of serum miR-338-3p and lung ultrasound score for prognosis of neonatal acute respiratory distress syndrome
Objective To explore the predictive value of serum miR-338-3p and lung ultrasound score(LUS)for prognosis of neonatal acute respiratory distress syndrome(ARDS).Methods From May 2019 to May 2022,a total of 120 neonatal patient with ARDS(ARDS group)were enrolled,which included 76 males and 44 females,gestational aged 28-40 weeks with mean gestational age of 32.32 weeks;birth body mass was 1.68-3.89 kg with mean body mass of 2.18 kg;neonatal Apgar score was 4-8 scores with mean score of 6.37 scores.There were 43 cases of spontaneous delivery and 57 of cesarean section.Among them,the etiology were 10 cases of sepsis,29 of premature delivery,25 of pneumonia,21 of meconium as-piration syndrome and 15 of other diseases.At the same period,50 normal newborns were enrolled as control group,which included 34 males and 16 females,gestational aged 31-40 weeks with mean gestational age of 33.04 weeks;birth body mass was 1.94-4.02 kg with mean body mass of 2.74 kg.There were 17 cases of spontaneous delivery and 33 of cesarean section.The neonatal patient with ARDS were divided into survival group and death group according to prognosis,while were divided into mild group and severe group according to results of chest X-ray.The real-time quantitative polymerase chain reaction(qPCR)was used to detect plasma level of miR-338-3p,and bedside LUS and neonatal acute physiology score perinatal supplement Ⅱ(SNAPPE-Ⅱ)were performed.The plasma miR-338-3p level and LUS were compared in dif-ferent groups,Pearson correlation analysis was used to analyze the correlation between SNAPPE-Ⅱ and plasma level of miR-338-3p,and LUS.The receiver operating characteristic(ROC)curve and Logistic regression analysis was used to ana-lyze the value of miR-338-3p and LUS for death or prognosis in neonatal patient with ARDS,respectively.Results The LUS of neonatal patient with ARDS was significantly higher than that of normal newborns[(29.45±3.42)scores vs(10.04±2.01)scores],and plasma miR-338-3p level was remarkably lower than that of normal newborns[(10.04±2.01)scores vs(1.12±0.11)scores](t=37.48,53.38,P＜0.001).The LUS and SNAPPE-Ⅱ score of severe group were significantly higher than those of mild group[(34.27±4.25)scores vs(18.97±2.11)scores,(31.84±3.52)scores vs(18.56±2.85)scores],and miR-338-3p level was significantly lower than that of mild group(0.28±0.02 vs 0.96±0.04)(P＜0.001).The SNAPPE-Ⅱ score was positively correlat ed with LUS(r=0.971,P＜0.001),and negatively correlated with miR-338-3p level(r=-0.918,P＜0.001).The LUS of death group was higher than that in survival group,and miR-338-3p level was remarkably lower than that in survival group[(37.02±3.63)scores vs(20.77±3.02)scores,(0.33±0.02)scores vs(0.75±0.02)scores.P＜0.001].The area under curve(AUC)of LUS,plasma miR-338-3p and their combination in predicting prognosis of neonatal patient with ARDS were 0.851,0.835 and 0.929,respectively.The plasma miR-338-3p and LUS were risk factors affecting the prognosis of ARDS patients(P＜0.05).Conclusion It is demonstrated that low-expression of miR-338-3p in serum of neonatal patient with ARDS and elevated LUS can predict the severity and prognosis of ARDS.
NETL
NSTL
万方数据
维普
