社区获得性肺炎患者淋巴细胞减少与血清中miR-182、miR-126水平变化的相关性研究

The correlation between lymphopenia and the changes of serum mir-182 and miR-126 levels in patients with community-acquired pneumonia

目的探讨社区获得性肺炎患者淋巴细胞减少与血清中miR-182、miR-126水平变化的相关性研究。方法选取2019年10月至2020年10月在本院呼吸内科住院的社区获得性肺炎患者153例为研究对象,根据患者入院当日血培养外周血淋巴细胞计数将患者分为非淋巴细胞减少组(淋巴细胞计数≥1.0×10^(9),n=104)和淋巴细胞减少组(淋巴细胞计数<1.0×10^(9),n=42)。收集患者的一般资料、炎症指标,RTPCR检测miR-182、miR-126的水平,采用Spearman相关分析分析miR-182、miR-126与其他炎症相关指标的相关性。结果淋巴细胞减少组患者急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)、肺炎严重度评分(PSI)、中症、重症患者比率和死亡患者均明显高于非淋巴细胞减少组,差异有显著性(P<0.05);淋巴细胞减少组患者降钙素原(PCT)、C反应蛋白(CRP)、白细胞、中粒细胞百分比、中粒细胞绝对值均明显高于非淋巴细胞减少组,差异有显著性(P<0.05);淋巴细胞减少组患者的血清中miR-182的相对表达明显高于非淋巴细胞减少组(P<0.05);淋巴细胞减少组患者的miR-126的相对表达显著低于非淋巴细胞减少组(P<0.05);与轻症患者相比,中症和重症患者血清中miR-182水平明显升高(P<0.05),其中重症患者血清中miR-182水平最高(P<0.05);中症和重症患者血清中miR-126水平显著降低(P<0.05),其中重症患者血清中miR-126水平最低(P<0.05);miR-182与APACHEⅡ评分、PSI评分、PCT、CRP、白细胞、中粒细胞百分比、中粒细胞绝对值呈正相关,miR-126与APACHEⅡ评分、PSI评分、PCT、CRP、白细胞、中粒细胞百分比、中粒细胞绝对值呈负相关(P<0.05);重症、PCT、CRP、中粒细胞百分比、中粒细胞绝对值、miR-182和miR-126是社区获得性肺炎患者淋巴细胞减少的影响因素(P<0.05)。结论社区获得性肺炎患者中淋巴细胞减少者,miR-182的表达升高,miR-126的表达降低,且与疾病炎症程度和炎症指标存在一定的相关性,可作为评估患者病情严重程度的标志物。

Objective To explore the correlation between lymphopenia and the changes of serum mir-182 and miR-126 levels in patients with community-acquired pneumonia.Methods 153 patients with community-acquired pneumonia hospitalized in the respiratory department of Shidong hospital,Yangpu District,Shanghai from October 2019 to October 2020 were retrospectively selected as the research objects.According to the peripheral blood lymphocyte count of blood culture on that day,the patients were divided into two groups(the non-lymphopenia group and the lymphopenia group).The lymphocyte count of non-lymphopenia group was≥1.0×10^(9),with 42 cases in total.In the lymphopenia group,the lymphocyte count was<1.0×10^(9),with a total of 104 cases.The general data and inflammatory indexes of patients were collected.The levels of mir-182 and miR-126 were detected by RT-PCR.The correlation between mir-182 and miR-126 and their related indexes was analyzed by Spearman correlation analysis.Results The acute physiological function and chronic health score systemⅡ(APACHEⅡ),pneumonia severity score(PSI),the ratio of moderate and severe patients and death patients in the lymphopenia group were significantly higher than those in the non-lymphopenia group(P<0.05).Procalcitonin(PCT),C-reactive protein(CRP),percentage of leukocytes,neutrophils and absolute value of neutrophils in the lymphopenia group were significantly higher than those in the non-lymphopenia group(P<0.05).The relative expression of mir-182 in serum of patients with lymphopenia group was significantly higher than that of the non-lymphopenia group(P<0.05).The relative expression of miR-126 in lymphopenia group was significantly lower than that in the non-lymphopenia group(P<0.05).Mir-182 was positively correlated with ApacheⅡscore,psi score,PCT,CRP,leukocyte,percentage of neutrophils and absolute value of neutrophils,while miR-126 was negatively correlated with ApacheⅡscore,psi score,PCT,CRP,leukocyte,percentage of neutrophils and absolute value of neutrophils,with statistical significance(P<0.05).Severe,PCT,CRP,percentage of neutrophils,absolute value of neutrophils,mir-182 and miR-126 were the influencing factors of lymphopenia in patients with community-acquired pneumonia,with statistical significance(P<0.05).Conclusion In patients with community-acquired pneumonia,the expression of mir-182 increased and the expression of miR-126 decreased in patients with lymphopenia,which has a certain correlation with the degree of disease inflammation and inflammatory indicators.It can be used as a marker to evaluate the severity of patients'condition.