miR⁃223和miR⁃192在重症肺炎患儿血清中的表达意义

Significance of miR⁃223 and miR⁃192 expression in serum of children with severe pneumonia

目的探讨微小RNA⁃223(miR⁃223)与微小RNA⁃192(miR⁃192)在重症肺炎患儿中的表达及其临床意义。方法选取120例肺炎患儿为研究组,根据儿童肺炎诊断标准将研究组分为轻度感染组、中度感染组与重度感染组,同时选取同期健康体检儿童120例为对照组。实时荧光定量聚合酶链反应(qRT⁃PCR)检测血清miR⁃223、miR⁃192的表达水平;采用免疫比浊法检测血清载脂蛋白E(ApoE)与C⁃反应蛋白(CRP)水平;化学发光法检测血清降钙素原(PCT)水平;Pearson法分析重症肺炎患儿血清miR⁃223、miR⁃192相关性及其两者表达与ApoE、CRP、PCT水平的相关性;受试者工作特征(ROC)曲线分析血清miR⁃223、miR⁃192对重症肺炎的诊断价值。结果与对照组相比,研究组血清miR⁃223的表达水平显著升高,血清miR⁃192的表达水平显著降低,差异有统计学意义(P<0.05);与轻度感染组相比,中度感染组与重度感染组血清miR⁃223的表达水平显著升高,血清miR⁃192的表达水平显著降低,差异有统计学意义(P<0.05);与对照组相比,研究组血清ApoE、CRP、PCT水平显著升高,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,重症肺炎患儿血清中miR⁃223和miR⁃192表达呈负相关(r=-0.226,P<0.001)。重症肺炎患儿血清中miR⁃223表达与ApoE、CRP、PCT呈正相关(P<0.001),miR⁃192表达与ApoE、CRP、PCT呈负相关(P<0.001)。血清中miR⁃223诊断重症肺炎时的敏感度为84.00%,特异度为74.00%,AUC面积为0.862;miR⁃192诊断重症肺炎时的敏感度为88.00%,特异度为72.00%,AUC面积为0.868。结论重症肺炎患儿血清miR⁃223表达水平升高,miR⁃192的表达水平降低,且与肺炎严重程度有关,并可能作为早期诊断重症肺炎的分子标志物。

Objective To investigate the expression and clinical significance of microRNA⁃223(miR⁃223)and microRNA⁃192(miR⁃192)in children with severe pneumonia.Methods 120 children with pneumonia were selected as the research group,and the research components were divided into mild infection group,moderate infection group and severe infection group according to the diagnostic criteria of childhood pneumonia.At the same time,120 children with healthy physical examination during the same period were se⁃lected as the control group.Real⁃time fluorescent quantitative polymerase chain reaction(qRT⁃PCR)was used to detect the serum levels of miR⁃223 and miR⁃192.Immunoturbidimetry was used to detect serum apolipopro⁃tein E(ApoE)and C⁃reactive protein(CRP)levels.Chemiluminescence method was used to detect serum procalcitonin(PCT)level.Pearson method was used to analyze the correlation between serum miR⁃223 and miR⁃192 in children with severe pneumonia and the correlation between their expression and ApoE,CRP,and PCT levels.The diagnostic characteristics of serum miR⁃223 and miR⁃192 were analyzed by ROC curve.Results Compared with the control group,the serum level of miR⁃223 in the study group was significantly increased(P<0.05),but miR⁃192decreased(P<0.05).Compared with the mild infection group,the serum level of miR⁃223 in the moderate infection and the severe infection group was significantly increased,and miR⁃192 reduced(P<0.05).Compared with the control group,the serum ApoE,CRP,and PCT levels in the study group in⁃creased significantly(P<0.05).Pearson correlation analysis showed that miR⁃223 and miR⁃192 expressions in children with severe pneumonia were negatively correlated(r=-0.226,P<0.001).The expression of miR⁃223 in serum of children with severe pneumonia was positively correlated with ApoE,CRP,and PCT(P<0.001),and the expression of miR⁃192 was negatively correlated with ApoE,CRP,and PCT(P<0.001).The sensitivi⁃ty of miR⁃223 in the diagnosis of severe pneumonia was 78.00%,the specificity was 90.00%,and the AUC ar⁃ea was 0.893.The sensitivity of miR⁃192 in the diagnosis of pneumonia was 80.00%,the specificity was 80.00%,and the AUC area was 0.902.Conclusion In children with severe pneumonia,the serum level of miR⁃223 increases and miR⁃192 decreases,which is related to the severity of pneumonia and can be used as a molecular marker for early diagnosis of severe pneumonia.