血清lncRNA ANRIL、lncRNA PVT1水平与急性呼吸窘迫综合征患儿病情及预后的关系

Relationships of serum lncRNA ANRIL and lncRNA PVT1 levels with the condition and prognosis of children with acute respiratory distress syndrome

目的探究血清长链非编码RNA INK4位点反义非编码RNA(lncRNA ANRIL)、长链非编码RNA浆细胞瘤变异易位基因1(lncRNA PVT1)水平与急性呼吸窘迫综合征(ARDS)患儿病情及预后的关系。方法选取124例确诊的ARDS患儿为患病组,另选取124例同期体检健康者为对照组。ARDS患儿根据病情严重程度分为重度组(34例)、中度组(42例)和轻度组(48例);ARDS患儿根据预后情况分为预后不良组(55例)和预后良好组(69例)。采用荧光定量聚合酶链反应测定血清中lncRNA ANRIL、lncRNA PVT1水平。采用Logistic回归分析法分析ARDS患儿发生预后不良的影响因素;采用受试者工作特征(ROC)曲线分析血清lncRNA ANRIL、lncRNA PVT1水平对ARDS患儿发生预后不良的预测价值。结果患病组的血清lncRNA ANRIL、lncRNA PVT1水平高于对照组,差异有统计学意义(P<0.05)。轻度组、中度组和重度组的血清lncRNA ANRIL、lncRNA PVT1水平随病情严重程度升高(P<0.05)。预后不良组的血清lncRNA ANRIL、lncRNA PVT1水平、氧合指数(OI)、呼吸频率、急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分高于预后良好组,差异有统计学意义(P<0.05);OI、呼吸频率、lncRNA ANRIL、lncRNA PVT1为患儿发生预后不良的影响因素(P<0.05)。血清lncRNA ANRIL、lncRNA PVT1水平预测ARDS患儿发生预后不良的曲线下面积(AUC)分别为0.827、0.737,截断值分别是11.35、4.36,二者联合预测的AUC为0.876。二者联合预测的AUC优于血清lncRNA ANRIL、lncRNA PVT1水平单独预测(P<0.05)。结论ARDS患儿的血清lncRNA ANRIL、lncRNA PVT1水平均上调,且lncRNA ANRIL、lncRNA PVT1为患儿发生预后不良的影响因素,二者联合预测的价值较高。

Objective To investigate the relationships of serum levels of long non-coding RNA antisense non-coding RNA in the INK4 locus(lncRNA ANRIL)and long non-coding RNA plasmacytoma variant translocation gene 1(lncRNA PVT1)with the condition of disease and prognosis of children with acute respiratory distress syndrome(ARDS).Methods A total of 124 children diagnosed with ARDS were selected as patient group,and another 124 healthy individuals undergoing physical examination during the same period were selected as control group.Children with ARDS were divided into severe group(34 cases),moderate group(42 cases),and mild group(48 cases)according to the severity of their condition.Based on prognosis,the children with ARDS were further categorized into poor prognosis group(55 cases)and good prognosis group(69 cases).Fluorescence quantitative polymerase chain reaction was used to determine the serum levels of lncRNA ANRIL and lncRNA PVT1.Logistic regression analysis was performed to analyze the influencing factors for poor prognosis in children with ARDS,and receiver operating characteristic(ROC)curve analysis was conducted to assess the predictive value of serum lncRNA ANRIL and lncRNA PVT1 levels for poor prognosis in these children.Results The serum levels of lncRNA ANRIL and lncRNA PVT1 in the patient group were significantly higher than those in the control group.(P<0.05).The serum levels of lncRNA ANRIL and lncRNA PVT1 increased with the severity of the condition in the mild,moderate and severe groups(P<0.05).The serum levels of lncRNA ANRIL,lncRNA PVT1,oxygenation index(OI),respiratory rate and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).OI,respiratory rate,lncRNA ANRIL and lncRNA PVT1 were identified as influencing factors for poor prognosis in children(P<0.05).The area under the curve(AUC)for predicting poor prognosis in children with ARDS based on serum lncRNA ANRIL and lncRNA PVT1 levels was 0.827 and 0.737,respectively,with cutoff values of 11.35 and 4.36.The combined prediction had an AUC of 0.876,which was superior to the individual prediction of serum lncRNA ANRIL and lncRNA PVT1 levels(P<0.05).Conclusion The serum levels of lncRNA ANRIL and lncRNA PVT1 are upregulated in children with ARDS,and both lncRNA ANRIL and lncRNA PVT1 are influencing factors for poor prognosis.The combined prediction of these two markers has high value.