急性呼吸窘迫综合征患儿血清miR-21水平与炎性因子水平及临床预后的关系

The relationship between serum miR-21 level and inflammatory factors and clinical prognosis in children with acute respiratory distress syndrome

目的分析血清miR-21水平与急性呼吸窘迫综合征(ARDS)患儿炎性因子水平及预后的关系。方法选择2016年3月—2019年2月海南省妇女儿童医学中心儿童重症医学科收治的ARDS患儿98例作为ARDS组,按照病情严重程度分为轻度(n=32)、中度(n=36)和重度(n=30);选取同期于医院体检的健康儿童90例作为对照组。比较2组血清miR-21表达水平,炎性因子[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和IL-17]的水平,采用Pearson相关分析血清miR-21表达水平与血清炎性因子的相关性,使用ROC曲线分析miR-21对ARDS患儿预后的预测价值。结果ARDS组患儿血清miR-21表达水平、TNF-α、IL-6和IL-17水平高于对照组(t=8.697、21.373、10.548、26.117,P均=0.000),并随着病情加重而增加(F=21.731、71.905、69.963、448.536,P均=0.000)。死亡亚组患儿入院时血清miR-21表达水平、TNF-α、IL-6和IL-17水平明显高于存活亚组(t=4.626、4.237、4.818、11.141,P均=0.000);血清miR-21表达量与TNF-α、IL-6和IL-17呈正相关(r=0.501、0.462、0.495,P均=0.000);血清miR-21表达水平预测ARDS患儿预后曲线下面积为0.796(95%CI 0.729~0.862),最佳临界值为1.54,敏感度和特异度分别为78.57%和82.65%,Youden指数为0.612。结论血清miR-21表达水平和炎性因子水平在ARDS患儿中明显升高,并随着病情加重而升高,血清miR-21表达水平和炎性因子水平呈正相关,血清miR-21的表达水平有助于评估患儿的病情严重状况和预后。

Objective To analyze the relationship between serum miR-21 level and inflammatory factors and prognosis in children with acute respiratory distress syndrome(ARDS).Methods Ninety-eight children with ARDS admitted to the Department of Pediatric Critical Medicine at Hainan Women and Children’s Medical Center from March 2016 to February 2019 as ARDS group,According to the severity of the disease,it can be divided into three categories:mild,moderate and severe.Meanwhile,90 healthy children were selected as the control group.The expression levels of serum miR-21 and inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-17(IL-17)]were compared between the two groups.Pearson correlation analysis between serum miR-21 expression and serum inflammatory factors.Prognostic value of miR-21 in children with ARDS by ROC curve analysis Results From March 2016 to February 2019,98 children with ARDS were selected as ARDS group.According to the severity of the disease,they were divided into mild(n=32),moderate(n=36)and severe(n=30).90 healthy children were selected as the control group.The expression level of miR-21 and the levels of inflammatory factors(TNF-α,IL-6 and IL-17)were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between the expression level of miR-21 and the serum inflammatory factors.ROC curve was used to analyze the predictive value of miR-21 in children with ARDS.Conclusion The expression level of serum miR-21 and inflammatory factors increased significantly in children with ARDS,and increased with the aggravation of the disease.The expression level of serum miR-21 was positively correlated with the level of inflammatory factors.The expression level of serum miR-21 was helpful to evaluate the severity and prognosis of the disease.