血清VCAM-l、TARC、miR-146a水平在小儿支气管哮喘合并支原体肺炎中的检测意义分析

Value of serum vascular cell adhesion molecule,thymus activation regulatory chemokine and miR-146a levels in detection of children with bronchial asthma and Mycoplasma pneumoniae pneumonia

目的探讨小儿支气管哮喘(BA)合并支原体肺炎(MPP)血清血管细胞黏附分子(VCAM-l)、胸腺活化调节趋化因子(TARC)、miR-146a水平及意义。方法选取2019年1月—2022年6月在本院治疗的BA患儿225例,根据有无合并MPP分为感染组(n=98)与非感染组(n=127)。比较2组患儿的一般资料、肺功能;采用荧光定量PCR检测并比较2组患儿miR-146a水平,采用酶联免疫吸附试验(ELISA)法检测并比较2组患儿VCAM-l、TARC水平;Pearson分析血清miR-146a水平与VCAM-l和TARC的相关性,采用ROC预测VCAM-l、TARC和miR-146a水平对BA合并MPP的诊断价值。结果感染组谷丙转氨酶(ALT)、谷草转氨酶(AST)水平高于非感染组(P<0.05),FVC和PEF水平低于非感染组(P<0.05);miR-146a水平与年龄、住院时间、体温、氧分压(PaO2)、呼吸速率和感染程度有关(P<0.05)。感染组VCAM-l、TARC和miR-146a表达水平均高于非感染组(P<0.05);患儿血清VCAM-l、TARC水平与miR-146a表达水平呈现正相关的关系(P<0.05);血清VCAM-l、TARC和miR-146a诊断BA合并MPP的AUC为0.713、0.763和0.769,联合检测预测价值高于各项指标单独检测(AUC=0.856,P<0.05)。结论患儿血清VCAM-l、TARC水平与miR-146a表达水平呈现正相关关系,临床可通过其水平变化诊断儿童BA合并MPP。

Objective This paper aims to explore the levels and significance of serum vascular cell adhesion molecule(VCAM-1),thymus activation regulatory chemokine(TARC)and miR-146a in children with bronchial asthma(BA)and Mycoplasma pneumoniae pneumonia(MPP).Methods A total of 225 children with BA treated in the hospital were enrolled between January 2019 to June 2022.According to presence or absence of MPP,they were divided into infection group(n=98)and non-infection group(n=127).The general data and lung function between the two groups were compared.The miR-146a level in both groups was detected and compared by fluorescence quantitative PCR.The levels of VCAM-1 and TARC in both groups were detected and compared by enzyme-linked immunosorbent assay(ELISA).The correlation between serum miR-146a and VCAM-1,TARC was analyzed by Pearson analysis.The diagnostic value of VCAM-1,TARC and miR-146a for BA combined with MPP was predicted by ROC curves.Results The levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in infection group were higher than those in non-infection group(P<0.05),while the levels of FVC and PEF were lower than those in non-infection group(P<0.05).The miR-146a level was correlated with age,hospitalization time,body temperature,oxygen partial pressure(PaO,),respiration rate and infection severity(P<0.05).The levels of VCAM-1,TARC and miR-146a in infection group were higher than those in non-infection group(P<0.05).The serum levels of VCAM-1 and TARC were positively correlated with miR-146a level(P<0.05).AUC values of serum VCAM-1,TARC and miR-146a in the diagnosis of BA combined with MPP were 0.713,0.763 and 0.769,respectively.The predictive value of combined detection was greater than that of single index(AUC=0.856,P<0.05).Conclusion The serum levels of VCAM-1 and TARC are positively correlated with miR-146a level.Clinically,changes of their levels can be applied in the diagnosis of BA combined with MPP in children.