血清miR-223及miR-155对新生儿肺炎的诊断价值研究

Study on the diagnostic value of serum miR-223 and miR-155 for neonatal pneumonia

目的探讨血清微小RNA(miR)-223、miR-155在新生儿肺炎患儿中的表达情况,及其对新生儿肺炎的诊断价值。方法选取2015年9月至2017年9月该院新生儿科收治的121例新生儿肺炎患儿作为新生儿肺炎组,另选取同期于该院正常分娩的120例健康新生儿作为对照组。采用全自动荧光免疫分析仪及配套试剂测定研究对象治疗前后血清中降钙素原(PCT)水平,采用全自动酶标仪测定治疗前后血清中白细胞介素-6(IL-6)水平并进行比较;采用实时荧光定量PCR(qRT-PCR)法检测两组血清中miR-223、miR-155相对表达水平并进行比较;Pearson分析miR-223、miR-155与PCT、IL-6的相关性;受试者工作特征(ROC)曲线分析miR-223、miR-155表达水平对新生儿肺炎的诊断价值。结果与对照组比较,新生儿肺炎组治疗前miR-223、miR-155、PCT及IL-6水平明显升高(P<0.05);两组治疗后miR-223、miR-155、PCT及IL-6水平比较,差异无统计学意义(P>0.05)。与治疗前比较,新生儿肺炎组治疗后miR-223、miR-155、PCT及IL-6水平明显降低(P<0.05)。Pearson相关性分析显示,两组miR-223与miR-155、PCT、IL-6表达呈正相关(P<0.05),miR-155与miR-223、PCT、IL-6表达呈正相关(P<0.05)。ROC曲线显示,血清miR-223、miR-155、PCT、IL-6水平诊断新生儿肺炎的曲线下面积(AUC)分别为0.886、0.825、0.812、0.831,灵敏度分别为85.9%、81.5%、82.7%、83.6%,特异度分别为82.7%、78.7%、77.3%、82.1%;四者联合诊断的AUC为0.956,灵敏度为96.2%,特异度为93.8%。结论miR-223、miR-155在新生儿肺炎患儿中高表达,miR-223、miR-155、PCT及IL-6联合检测可明显提高新生儿肺炎的诊断灵敏度及特异度。

Objective To explore the expression of serum microRNA(miR)-223 and miR-155 in children with neonatal pneumonia and their diagnostic value for neonatal pneumonia.Methods The 121 neonatal pneumonia patients admitted to the neonatal department of the hospital from September 2015 to September 2017 were selected as the neonatal pneumonia group,and 120 healthy newborns who gave birth in the hospital during the same period were selected as the control group.The automatic fluorescence immunoassay analyzer and supporting reagents were used to determine the serum procalcitonin(PCT)levels of the subjects before and after treatment,and the automatic microplate reader was used to determine the serum interleukin-6(IL-6)levels before and after treatment.Real-time fluorescence quantitative PCR(qRT-PCR)was used to detect the relative expression levels of miR-223 and miR-155 in the two groups;Pearson was analyzed the correlation among miR-223,miR-155,PCT and IL-6;receiver operating characteristic(ROC)curve was used to analyze the diagnosis of miR-223,miR-155 expression level in neonatal pneumonia.Results Compared with the control group,the levels of miR-223,miR-155,PCT and IL-6 were significantly higher in the neonatal pneumonia group before treatment(P<0.05),after treatment,there was no statistical significant difference in the levels of miR-223,miR-155,PCT and IL-6 between the two group(P>0.05).Compared with before treatment,the levels of miR-223,miR-155,PCT and IL-6 in the neonatal pneumonia group after treatment were significantly lower(P<0.05);Pearson correlation analysis showed that miR-223 was positively correlated with miR-155,PCT and IL-6(P<0.05),while miR-155 was positively correlated with miR-223,PCT and IL-6(P<0.05);ROC showed that area under the curve(AUC)of miR-223,miR-155,PCT,IL-6 for neonatal pneumonia was 0.886,0.825,0.812,0.831,respectively,while sensitivity was 85.9%,81.5%,82.7%,83.6%,respectively,and specificity was 82.7%,78.7%,77.3%,and 82.1%,respectively.AUC of the combined diagnosis of the four was 0.956,sensitivity was 96.2%,and specificity was 93.8%.Conclusion MiR-223 and miR-155 highly expresses in neonatal pneumonia,the combined detection of miR-223,miR-155,PCT and IL-6 significantly improves the diagnostic sensitivity and specificity.