儿童原发性肾病综合征患者外周单个核细胞miR-199a、miR-196水平与临床症状的相关性及诊断价值

The Correlation Between the Levels of Peripheral Mononuclear Cells miR-199a and miR-196 and the Clinical Symptoms in Children with Primary Nephrotic Syndrome and its Diagnostic Value

目的:分析儿童原发性肾病综合征患者外周单个核细胞miR-199a、miR-196水平与临床症状的相关性及其诊断价值。方法:收集2017年2月—2019年5月在我院就诊的原发性肾病综合征的患儿60例,作为实验组,同时又选择同时期体检的健康儿童60例作为对照组,采用实时荧光定量PCR技术检测两组儿童外周血单个核细胞中的miR-199a、miR-196水平,同时检测血清总蛋白、白蛋白、总胆固醇、三酰甘油和肾功能指标(尿素、肌酐、尿酸、尿蛋白)水平,分析miR-199a、miR-196与临床症状的相关性及临床诊断价值。结果:与健康对照组相比,实验组患儿血清总蛋白、白蛋白均降低,总胆固醇、三酰甘油、尿酸指标则升高,差异具有统计学意义(P<0.05)。两组的尿素和肌酐相比较,差异无统计学意义(P>0.05)。实验组miR-199a、miR-196的表达水平均明显低于对照组,差异具有统计学意义(P<0.05)。根据ROC曲线分析结果显示,miR-199a对诊断PNS的ROC曲线下面积为0.843,敏感性和特异度为74.31%、87.84%;miR-196对诊断PNS的ROC曲线下面积为0.846,敏感性和特异度为92.66%、72.97%。在实验组患儿中,根据Pearson相关性分析结果,miR-199a水平与白蛋白、总胆固醇、三酰甘油、尿蛋白显著负相关(P<0.05),miR-196水平与白蛋白、总胆固醇、尿蛋白显著负相关(P<0.05)。结论:PNS患儿的外周单个核细胞内的miR-199a、miR-196水平与肾功能损伤的指标相关,对于诊断PNS均有较高的敏感性和特异性,对于PNS的诊断具有一定的临床价值。

Objective:To analyze the correlation between the levels of peripheral mononuclear cells miR-199a and miR-196 and the clinical symptoms in children with primary nephrotic syndrome and its diagnostic value.Methods:A total of 60 children with primary nephrotic syndrome admitted to our hospital from February 2017 to May 2019 were collected,as the experimental group,and select 60 cases with medical health children as control group,using real-time fluorescent quantitative PCR technique to detect peripheral blood mononuclear cells in two groups of children of miR-199a and miR-196 levels,while detecting the serum TP,Alb,TC,TG and renal index(urea,creatinine,uric acid,urine protein)level,the analysis of miR-199a and miR-196 and the correlation of clinical symptoms and clinical diagnostic value.Results:Compared with the healthy control group,the serum TP and Alb in the experimental group were decreased,while the serum TC,TG and uric acid were increased(P<0.05).There was no significant difference in urea and creatinine between the two groups(P>0.05).The expression levels of miR-199a and miR-196 in the experimental group were significantly lower than those in the control group,with statistically significant differences(P<0.05).According to the ROC curve analysis results,the area under the ROC curve of miR-199a for the diagnosis of PNS was 0.843,and the sensitivity and specificity were 74.31%and 87.84%.The area under the ROC curve of miR-196 pair for diagnosing PNS was 0.846,and the sensitivity and specificity were 92.66%and 72.97%.In the children of the experimental group,Pearson correlation analysis results showed that miR-199a level was significantly negatively correlated with Alb,TC,TG and urine protein(P<0.05),and miR-196 level was significantly negatively correlated with Alb,TC and urine protein(P<0.05).Conclusion:The levels of miR-199a and miR-196 in peripheral mononuclear cells of children with PNS are related to the indicators of renal function injury,which have high sensitivity and specificity for the diagnosis of PNS,and have certain clinical value for the diagnosis of PNS.