脓毒症患儿血浆miR-146a、miR-223表达与IL-6、IL-10、TNF-α水平变化的临床意义分析

Analysis of the Clinical Significances of Plasma miR-146a,miR-223,IL-10,TNF-α and IL-6 Levels in Children with Sepsis

目的:探讨脓毒症患儿血浆微RNA-146a(miR-146a)、miR-223表达及与白细胞介素-6(IL-6)、IL-10和肿瘤坏死因子(TNF-α)的关系。方法:选取2016年2月至2017年2月在我院治疗的脓毒症患儿44例作为脓毒症组,同时选取32例全身性炎症反应综合征(SIRS)患儿(SIRS组)和40例健康儿童(对照组),检测和比较各组患儿血浆miR-146a、miR-223、IL-6、IL-10和TNF-α的表达,同时采用序贯器官衰竭估计评分(SOFA评分)评价脓毒症患儿的病情。结果:脓毒症组miR-146a、miR-223、IL-6和IL-10表达分别为(5.90±1.22)×10^(-5)、(13.17±2.13)×10^(-4),20.21(12.06,64.13)ng/L和17.60(8.94,70.11)pg/m L,明显高于SIRS组和对照组(P<0.05);脓毒症组和SIRS组血浆TNF-水平分别为(22.50(22.50,29.80)pg/m L和(23.40(19.41,30.01)pg/m L,明显高于对照组(P<0.05);患儿miR-146a、miR-223与SOFA评分呈正相关(rs=0.411和0.321,P<0.05),而血浆IL-6、IL-10及TNF-α水平与SOFA评分无显著相关性(P>0.05);miR-146a与血浆IL-6、IL-10水平呈显著正相关(rs=0.297和0.301,P<0.05),miR-223与血浆TNF-α水平呈正相关(rs=0.284,P<0.05)。结论:脓毒症患儿血浆miR-146a和miR-223表达、IL-6、IL-10和TNF-α水平均异常上调,且血浆miR-146a和miR-223表达与IL-6、IL-10、TNF-水平及病情程度显著相关。

Objective： To investigate the clinical significance of plasma micro RNA-146a （miR-146a）, miR-223 and intefleukin -6 （IL-6）, IL-10 and tumor necrosis factor （TNF-ct） levels in children with sepsis. Methods： From February 2016 to February 2017, 44 children with sepsis （sepsis group）, 32 children with systemic inflammatory response syndrome （SIRS） （SIRS group） and 40 healthy children （control group） in our hospital were selected, the plasma levels ofmiR-146a, miR-223, IL6, IL-10, and TNF-α were detected, the sequential organ failure assessment score （SOFA score） was used to assess the severity of sepsis. Results： The plasma levels ofmiR-146a, miR-223, IL-6 and IL-10 in sepsis group were （5.90± 1.22）×10^-5, （13.17± 2.13）×10^-4, 20.21 （12.06, 64.13） ng/L and 17.60 （8.94,70.11） pg/mL, which were significantly higher than those of the SIRS group and control group （P〈0.05）; The plasma TNF-α levels of Sepsis group and SIRS group were 22.50 （22.50, 29.80） pg/mL and 23.40 （19.41, 30.01） pg/mL, which were significantly higher than that of the control group （P〈0.05）; the plasma miR-146a, miR-223 expressions were positively correlated with the SOFA score （rs=0.411 and 0.321, P 〈 0.05）, while the plasma IL-6, IL-10 and TNF-α level showed no correlation with SOFA score （P 〉 0.05）; plasma miR-146a level was positively correlated with the plasma IL-6 and IL-10 levels （rs=0.297 and 0.301, P 〈 0.05）, the plasma miR-223 and TNF-ct levels were positively related （rs=0.284, P 〈 0.05）. Conclusion： The expression ofmiR-146a and miR-223 in plasma were significantly increased in children with sepsis, which were related to the plasma IL-6, IL-10 and TNF-α levels and had a certain role in evaluating the disease severity.