新生儿缺氧缺血性脑病血清miR-384与炎症反应、神经行为的相关分析

Correlations of serum miR-384 level with inflammatory response and neurobehavior in neonates with hypoxic-ischemic encephalopathy

目的 探讨新生儿缺氧缺血性脑病(HIE)血清微小分子核糖核酸-384(miR-384)表达水平与炎症反应、辅助性T细胞17/调节性T细胞(Th17/Treg)失衡及神经行为的相关性。方法 选择2015年10月至2020年10月唐山市妇幼保健院收治的106例HIE患儿为HIE组,另选取同期同院产科分娩的90例健康新生儿为对照组。参考HIE分度标准将患儿分成轻、中、重度组,比较各组血清miR-384、白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、Treg、Th17、Th17/Treg与新生儿神经行为量表(NBNA)评分。经Pearson线性相关分析HIE患儿血清miR-384与炎症因子、Treg、Th17、Th17/Treg、NBNA评分的相关性。结果 HIE组血清miR-384、Treg水平及NBNA评分低于对照组,Th17、Th17/Treg、IL-6、CRP、TNF-α水平高于对照组,差异均有统计学意义(t值介于-21.533~30.802之间,P<0.05);HIE轻、中、重度组血清miR-384、Treg水平及NBNA评分均依次降低,Th17、Th17/Treg、IL-6、CRP、TNF-α水平均依次升高,差异有统计学意义(F值介于82.368~513.891之间,P<0.05);HIE患儿血清miR-384与IL-6、CRP、TNF-α、Th17、Th17/Treg呈负相关(r值介于-0.867~-0.406之间,P<0.05),与Treg、NBNA评分呈正相关(r值分别为0.671、0.776,P<0.05)。结论 HIE患儿病情越重,miR-384水平下降越明显;miR-384表达与患儿的炎症反应、Th17/Treg免疫平衡及神经行为能力密切相关。

Objective To explore correlations of serum micro-molecular ribonucleic acid-384(miR-384) expression level with inflammation response, helper T cell 17/regulatory T cell(Th17/Treg) imbalance and neural behavior in neonates with hypoxic-ischemic encephalopathy(HIE). Methods 106 neonates with HIE who admitted to Department of Neonatology, Tangshan Municipal Maternity and Child Health Hospital from October 2015 to October 2020 were selected as HIE group, and 90 healthy newborns who were born in Department of Obstetrics of our hospital in the same period were selected as control group. The neonates with HIE were divided into mild HIE group, moderate HIE group and severe HIE group according to HIE grading criteria. The serum levels of miR-384, interleukin-6(IL-6), C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), Treg, Th17, Th17/Treg and score in neonatal behavioral neurological assessment(NBNA) of the neonates were compared among the four groups. Pearson linear correlation analysis was used to analyze correlations of serum miR-384 level with inflammatory factors, Treg, Th17, Th17/Treg and score in NBNA in the neonates with HIE.Results The serum levels of miR-384 and Treg and score in NBNA of the neonates in the HIE group were lower than those in the control group, while their serum levels of Th17, Th17/Treg, IL-6, CRP and TNF-α were higher than those in the control group, and the differences were statistically significant(t values ranged from-21.533-30.802, all P<0.05). The serum miR-384 and Treg levels and score in NBNA of the neonates with HIE in the HIE mild group, the moderate HIE group and the severe HIE group were decreased in turn, while the serum levels of Th17, Th17/Treg, IL-6, CRP and TNF-α were increased in turn, and the differences were statistically significant(F values ranged from 82.368-513.891, all P<0.05). The serum level of miR-384 was negatively correlated with the serum levels of IL-6, CRP, TNF-α, Th17 and Th17/Treg in the neonates with HIE(r values ranged from-0.867--0.406, all P<0.05), and positively correlated with Treg and score in NBNA(r values were 0.671 and 0.776 respectively, both P<0.05). Conclusion The more severe the disease of HIE, the more significant the decline of serum miR-384 level. The expression of miR-384 is closely related to inflammatory response, Th17/Treg immune balance and neurobehavioral ability of the neonate.