RDS早产儿SPOCK2、RELM-β、miR-21水平变化及相关性研究

Changes and correlations of SPOCK2,RELM-β and miR-21 levels in premature infants with RDS

目的 探究呼吸窘迫综合征(RDS)早产儿睾素2(SPOCK2)、抵抗素样分子β(RELM-β)、微小RNA-21(miR-21)水平变化及相关性。方法 选取2019年1月至2020年1月在该院住院的50例RDS早产儿作为研究组,另选取同期于该院产科出生的50例健康早产儿作为对照组。研究组根据病情严重程度分为轻度组(20例)和中重度组(30例),根据神经发育有无损伤分为预后良好组(38例)和预后不良组(12例)。采用酶联免疫吸附实验检测所有受试早产儿SPOCK2、RELM-β水平,采用实时荧光定量聚合酶链反应检测miR-21水平。比较研究组与对照组及不同病情严重程度、预后、临床病理特征RDS早产儿SPOCK2、RELM-β、miR-21水平,分析RDS早产儿SPOCK2、RELM-β、miR-21水平的相关性。采用受试者工作特征(ROC)曲线分析SPOCK2、RELM-β、miR-21单独和联合检测对早产儿RDS的诊断价值。结果 研究组SPOCK2、RELM-β、miR-21水平均高于对照组(P<0.05)。SPOCK2水平与RELM-β、miR-21均呈正相关(r=0.459、0.552,P<0.05),RELM-β水平与miR-21呈正相关(r=0.489,P<0.05)。中重度组SPOCK2、RELM-β、miR-21水平均高于轻度组(P<0.05)。预后不良组SPOCK2、RELM-β、miR-21水平均高于预后良好组(P<0.05)。新生儿窒息、母亲产前未使用糖皮质激素的RDS早产儿SPOCK2、RELM-β、miR-21水平高于无新生儿窒息、母亲产前使用糖皮质激素的RDS早产儿(P<0.05)。ROC曲线分析结果显示,SPOCK2、RELM-β、miR-21联合检测诊断早产儿RDS的曲线下面积、灵敏度、特异度、准确度均高于单独检测(P<0.05)。结论 RDS早产儿SPOCK2、RELM-β、miR-21水平均升高且相互呈正相关,3项指标联合检测对早产儿RDS具有一定诊断价值。

Objective To investigate the changes and correlations of testosterone 2(SPOCK2),resistin-like molecule β(RELM-β) and microRNA-21(miR-21) levels in premature infants with respiratory distress syndrome(RDS).Methods Fifty premature infants with RDS who were hospitalized in this hospital from January 2019 to January 2020 were selected as the study group, and 50 healthy premature infants born in the department of obstetrics of this hospital during the same period were selected as the control group.The study group was divided into the mild group(20 cases) and the moderate-severe group(30 cases) according to the severity of the disease, and divided into the good prognosis group(38 cases) and the poor prognosis group(12 cases) according to the neurodevelopmental damage.The levels of SPOCK2 and RELM-β in all preterm infants were detected by enzyme-linked immunosorbent assay, and the level of miR-21 was detected by real-time fluorescence quantitative polymerase chain reaction.The levels of SPOCK2,RELM-β and miR-21 were compared between the study group and the control group and in preterm infants with RDS with different disease severity, prognosis and clinicopathological characteristics.The correlation of SPOCK2,RELM-β and miR-21 levels in premature infants with RDS was analyzed.Receiver operator characteristics(ROC) curve was used to analyze the diagnostic value of SPOCK2,RELM-β and miR-21 alone and in combined detection in the diagnosis of RDS in premature infants.Results The levels of SPOCK2,RELM-β and miR-21 in the study group were higher than those in the control group(P<0.05).The level of SPOCK2 was positively correlated with RELM-β and miR-21(r=0.459,0.552,P<0.05),and the level of RELM-β was positively correlated with miR-21(r=0.489,P<0.05).The levels of SPOCK2,RELM-β and miR-21 in the moderate-severe group were higher than those in the mild group(P<0.05).The levels of SPOCK2,RELM-β and miR-21 in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The levels of SPOCK2,RELM-β and miR-21 in RDS preterm infants with neonatal asphyxia and mothers who did not use glucocorticoids before birth were higher than those of RDS preterm infants without neonatal asphyxia and mothers who used glucocorticoids before birth(P<0.05).The results of ROC curve analysis showed that the combined detection of SPOCK2,RELM-β,and miR-21 had higher the area under the curve, the sensitivity, the specificity and the accuracy than single detection for diagnosis of RDS in premature infants(P<0.05).Conclusion The levels of SPOCK2,RELM-β and miR-21 in premature infants with RDS are all elevated and positively correlated with each other.The combined detection of the three indicators has certain diagnostic value for RDS in premature infants.