肺炎支原体肺炎患儿血清miR-126-5p、SPP1表达水平与病情严重程度的相关性分析

Correlation analysis of serum miR-126-5p and SPP1 expression levels and disease severity in children with Mycoplasma pneumoniae pneumonia

目的探讨肺炎支原体肺炎(MPP)患儿血清微小RNA-126-5p(miR-126-5p)、分泌性磷蛋白1(SPP1)表达及与病情严重程度的相关性。方法回顾性选取2018年6月至2021年10月在北大荒集团总医院治疗的199例MPP患儿作为观察对象,急性期106例,缓解期93例,根据临床肺部感染评分(CPIS)将急性期MPP患儿分为轻症组(CPIS≤6分)59例和重症组(CPIS>6分)47例,另选取同期健康体检儿童50例作为对照组。采用RT-qPCR检测血清miR-126-5p水平;酶联免疫吸附试验检测血清SPP1、超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6、IL-1β水平;Pearson法分析急性期MPP患儿血清miR-126-5p、SPP1与hs-CRP、IL-6、IL-1β水平的相关性;Spearman法分析miR-126-5p、SPP1水平与CPIS评分的相关性;采用受试者工作特征(ROC)曲线分析血清miR-126-5p、SPP1对重症MPP患儿的预测价值。结果对照组、缓解期组、急性期组观察对象血清miR-126-5p、SPP1、hs-CRP、IL-6、IL-1β水平比较,差异均有统计学意义(P<0.05)。与轻症MPP患儿比较,重症MPP患儿血清miR-126-5p、SPP1、hs-CRP、IL-6、IL-1β水平及CPIS评分显著升高,差异均有统计学意义(P<0.05)。相关性分析显示,急性期MPP患儿血清miR-126-5p与SPP1呈正相关,且miR-126-5p、SPP1与hs-CRP、IL-6、IL-1β水平及CPIS评分呈正相关(P<0.001)。血清miR-126-5p、SPP1联合诊断重症MPP患儿曲线下面积为0.935,敏感度为86.79%,特异度为91.53%。结论MPP患儿血清miR-126-5p、SPP1水平升高,与患儿疾病严重程度有关,可作为MPP患儿病情评估的标志物。

Objective To investigate the expression of serum microRNA-126-5p(miR-126-5p)and secreted phosphoprotein-1(SPP1)in children with Mycoplasma pneumoniae pneumonia(MPP)and their correlation with disease severity.Methods A total of 199 children with MPP who were treated in General Hospital of Beidahuang Group from June 2018 to October 2021 were collected as the observation objects,including 106 in the acute stage and 93 in the remission stage.According to the clinical pulmonary infection score(CPIS),children with acute MMP were grouped into mild group(CPIS≤6 points)with 59 cases and severe group(CPIS>6 points)with 47 cases.In addition,50 healthy children were gathered as the control group.The serum miR-126-5p level was detected by RT-qPCR,serum SPP1,hypersensitive C-reactive protein(hs-CRP),interleukin(IL)-6,and IL-1βlevels were detected by enzyme-linked immunosorbent assay,the correlation of miR-126-5p,SPP1 and hs-CRP,IL-6,IL-1βlevels in children with acute MPP was analyzed by Pearson method,the correlation between the levels of miR-126-5p and SPP1 and the CPIS score was analyzed by Spearman method,the predictive value of serum miR-126-5p and SPP1 in children with severe MPP was analyzed by receiver operating characteristic(ROC)curve.Results There were statistically significant differences in the levels of serum miR-126-5p,SPP1,hs-CRP,IL-6,and IL-1βamong the observation subjects in the control group,the remission group,and the acute group,the differences were statistically significant(P<0.05);compared with children with mild MPP,the levels of serum miR-126-5p,SPP1,hs-CRP,IL-6,IL-1βand CPIS score in children with severe MPP were significantly higher,the differences were statistically significant(P<0.05);correlation analysis showed that serum miR-126-5p was positively correlated with SPP1 in children with acute MPP,and miR-126-5p and SPP1 were positively correlated with hs-CRP,IL-6,IL-1βlevels and CPIS score(P<0.001);the area under the curve of serum miR-126-5p and SPP1 in the diagnosis of children with severe MPP was 0.935,the sensitivity was 86.79%,and the specificity was 91.53%.Conclusion The serum levels of miR-126-5p and SPP1 in children with MPP are elevated,which are related to the severity of the disease in children,and may be used as markers for the assessment of the disease of children with MPP.