川崎病患儿血清微小RNA-27a、过氧化物酶体增殖物激活受体γ水平与冠状动脉病变的关系

Relationship between Serum MicroRNA-27a and Peroxisome Proliferator-activated ReceptorγLevels and Coronary Artery Disease in Children with Kawasaki Disease

目的分析川崎病(KD)患儿血清微小RNA(miR)-27a、过氧化物酶体增殖物激活受体γ(PPARγ)水平与冠状动脉病变(CAL)的关系。方法选取2016年1月至2021年1月德州市妇幼保健院100例KD患儿,其中51例合并CAL(CAL组),49例未合并CAL(非CAL组)。49例CAL组KD患儿根据CAL严重程度分级标准分为轻度CAL组(16例)、中度CAL组(20例)、重度CAL组(15例)。同时选取同期体检的50名健康儿童作为健康对照组。比较各组受试儿童血清miR-27a、PPARγ水平。采用多因素logistic分析KD患儿发生CAL的影响因素。绘制受试者操作特征(ROC)曲线分析血清miR-27a、PPARγ水平对CAL的诊断效能。结果健康对照组受试儿童、非CAL组及CAL组KD患儿血清miR-27a水平逐次增加(P<0.05);非CAL组KD患儿血清PPARγ水平高于CAL组KD患儿、健康对照组受试儿童(P<0.05),而CAL组KD患儿血清PPARγ水平高于健康对照组受试儿童(P<0.05)。轻度CAL组、中度CAL组、重度CAL组KD患儿血清miR-27a水平依次升高(P<0.05),而PPARγ水平逐次降低(P<0.05)。多因素logistic分析结果显示,miR-27a、PPARγ、C反应蛋白水平及红细胞沉降率是KD发生CAL的影响因素(P<0.05);ROC曲线显示,血清miR-27a、PPARγ水平诊断KD患儿CAL的曲线下面积分别为0.932、0.925,血清miR-27a水平联合血清PPARγ水平诊断KD患儿CAL的曲线下面积为0.976。结论血清miR-27a、PPARγ水平与KD患儿冠状动脉损伤有关,对CAL的发生有一定的诊断价值。

Objective To detect the levels of serum microRNA(miR)-27a and peroxisome proliferator-activated receptorγ(PPARγ)in children with Kawasaki disease(KD),and to analyze their relationship with coronary artery lesions(CAL).Methods From January 2016 to January 2021,49 KD children without CAL(non-CAL group)and 51 KD children with CAL(CAL group)in Dezhou Maternal and Child Health Hospital were selected as the research objects.The CAL group was divided into mild CAL group(16 cases),moderate CAL group(20 cases),and severe CAL group(15 cases)according to the CAL severity grading standard.In addition,healthy children with underwent physical examination during the same period were selected as the control group(50 cases).Comparison of serum miR-27a and PPARγlevels in each group.Multivariate logistic analysis was used to analyze the related factors affecting CAL in children with KD.Receiver operating characteristic(ROC)curve analysis of serum miR-27a and PPARγlevels in the diagnosis of CAL.Results The levels of serum miR-27a in the control group,non-CAL group and CAL group increased successively(P<0.05).The serum PPARγlevel in the non-CAL group was higher than that in the CAL group and the control group,while the CAL group was higher than the control group(P<0.05).The levels of serum miR-27a in mild CAL group,moderate CAL group,and severe CAL group increased successively(P<0.05),while the level of PPARγdecreased successively(P<0.05).Regression analysis showed that,miR-27a,PPARγ,C-reactive protein and erythrocyte sedimentation rate were the influencing factors of CAL in KD(P<0.05).ROC results showed that,the area under the curve of miR-27a and PPARγin the diagnosis of CAL was 0.932 and 0.925,respectively,and the area under the curve in the diagnosis of miR-27a combined with PPARγwas 0.976.Conclusion Serum miR-27a and PPARγare related to coronary artery injury in children with KD,and have certain diagnostic value for the occurrence of CAL.