支气管肺泡灌洗液中miR-17和VEGF表达与低出生体重儿支气管肺发育不良的关系

The Relationships between the Expressions of MiR-17 and Vascular Endothelial Growth Factor in Bronchoalveolar Lavage Fluid with Bronchopulmonary Dysplasia in Low Birth Weight Infants

目的探讨支气管肺泡灌洗液(BALF)中微小RNA-17(miR-17)、血管内皮生长因子(VEGF)表达水平与低出生体重儿支气管肺发育不良(BPD)的关系。方法选取95例低出生体重儿作为受试对象,根据是否进行机械通气及机械通气是否发生BPD将其分为对照组(单纯低出生体重儿)30例、机械通气非BPD组33例、机械通气BPD组32例。采用实时荧光定量PCR(qRT-PCR)检测BALF中miR-17水平,采用酶联免疫吸附试验(ELISA)检测BALF中VEGF水平;机械通气BPD组患儿根据BPD临床分度标准分为轻度BPD 10例、中度BPD 12例、重度BPD 10例。结果三组患儿BALF中miR-17、VEGF水平差异有统计学意义(P<0.05);机械通气BPD组患儿BALF中miR-17水平最低、VEGF水平最高,其次为机械通气非BPD组患儿,对照组患儿BALF中miR-17水平最高、VEGF水平最低,两两比较差异均有统计学意义(P<0.05)。随着机械通气时间延长,机械通气非BPD组、机械通气BPD组患儿BALF中miR-17水平逐渐降低、VEGF水平逐渐提高,且同组不同通气时段两两比较,差异均有统计学意义(P<0.05);不同通气时段机械通气BPD组患儿BALF中miR-17水平显著低于机械通气非BPD组(P<0.05),VEGF水平明显高于机械通气非BPD组(P<0.05)。机械通气BPD组患儿不同程度BALF中miR-17、VEGF水平差异有统计学意义(P<0.05);重度BPD患儿BALF中miR-17水平最低、VEGF水平最高,其次为中度BPD患儿,轻度BPD患儿BALF中miR-17水平最高、VEGF水平最低,两两比较差异均有统计学意义(P<0.05)。机械通气BPD组患儿BALF中miR-17、VEGF水平呈负相关(r=-0.699,P<0.05)。结论BALF中miR-17水平降低、VEGF水平升高,与低出生体重儿支气管肺发育不良有关,动态监测BALF中miR-17、VEGF水平,有利于BPD早发现、早治疗。

Objective To investigate the relationships between the expressions of microRNA-17(microRNA-17)and vascular endothelial growth factor(VEGF)in bronchoalveolar lavage fluid(BALF)with bronchopulmonary dysplasia(BPD)in low birth weight infants.Methods 95 low birth weight infants were selected as subjects,they were divided into control group(30 cases of simple low birth weight infants),non-BPD mechanical ventilation group(33 cases),and mechanical ventilation BPD group(32 cases)according to whether mechanical ventilation was performed and whether BPD occurred during mechanical ventilation.Real-time fluorescence quantitative PCR(qRT-PCR)was used to detect the level of microRNA-17 in BALF,enzyme-linked immunosorbent assay(ELISA)was used to detect the level of vascular endothelial growth factor(VEGF)in BALF;the patients in mechanical ventilation BPD group were divided into 10 cases of mild BPD,12 cases of moderate BPD,and 10 cases of severe BPD according to the clinical grading standard of BPD.Results There were significant differences in the levels of microRNA-17 and vascular endothelial growth factor in BALF among the three groups(P<0.05);the level of microRNA-17 in BALF in mechanical ventilation BPD group was the lowest and the level of vascular endothelial growth factor was the highest,the following was children in non-BPD mechanical ventilation group,the level of microRNA-17 in BALF in the control group was the highest and the level of vascular endothelial growth factor was the lowest,there were significant differences between any two groups(P<0.05).With the prolongation of mechanical ventilation,the level of microRNA-17 decreased gradually,and the level of vascular endothelial growth factor increased gradually in BALF of children in non-BPD mechanical ventilation group and mechanical ventilation BPD group,and there were significant differences between the same groups in different ventilation periods(P<0.05);The level of microRNA-17 in BALF of children in mechanical ventilation BPD group at different ventilation periods was significantly lower than that of non-mechanical ventilation BPD group(P<0.05),the level of vascular endothelial growth factor was significantly higher in non-BPD mechanical ventilation group(P<0.05).There were significant differences in the levels of microRNA-17 and vascular endothelial growth factor of children with different degrees of BALF in mechanical ventilation BPD group(P<0.05);the level of microRNA-17 in BALF of children with severe BPD was the lowest and the level of vascular endothelial growth factor was the highest,the following was children with severe BPD,the level of microRNA-17 in BALF of children with mild BPD was the highest and the level of vascular endothelial growth factor was the lowest,there were significant differences between any two groups(P<0.05).The levels of microRNA-17 and vascular endothelial growth factor in BALF of children in mechanical ventilation BPD group were negatively correlated(r=-0.699,P<0.05).Conclusion The level of microRNA-17 in BALF is decreased and the level of vascular endothelial growth factor is increased,which is related to bronchopulmonary dysplasia in low birth weight infants,dynamic monitoring of microRNA-17 and vascular endothelial growth factor levels in BALF is conducive to early detection and treatment of BPD.