血清微小RNA-4731-5p和间皮素水平与需治疗原发免疫性血小板减少症发生相关性研究

Correlation between serum miR-4731-5p,MSLN levels and occurrence of primary immune thrombocytopenia requiring treatment

目的:探究血清微小RNA-4731-5p(miR-4731-5p)和间皮素(MSLN)水平与需治疗原发免疫性血小板减少症(ITP)发生的相关性。方法:选择ITP患者118例,根据血小板(PLT)计数及是否伴有出血分为需治疗组(62例)和需观察组(56例)。另选取体检健康者60例为对照组。采用全自动血液分析仪检测白细胞计数、血红蛋白、PLT及平均血小板体积(MPV)水平。采用实时荧光定量PCR和酶联免疫吸附法分别对血清miR-4731-5p和MSLN水平进行测定。比较三组血常规及血清miR-4731-5p、MSLN水平。分析ITP患者血清miR-4731-5p、MSLN、PLT、MPV间的相关性,影响需治疗ITP发生的因素,以及血清miR-4731-5p、MSLN对需治疗ITP发生的预测价值。结果:对照组、需观察组、需治疗组PLT、血清miR-4731-5p水平依次降低,MPV、血清MSLN水平依次升高(均P<0.05)。ITP患者血清miR-4731-5p与MSLN呈负相关(r=-0.683,P<0.05);miR-4731-5p与PLT呈正相关,与MPV呈负相关(r=0.401、-0.564,均P<0.05);MSLN与PLT呈负相关,与MPV呈正相关(r=-0.429、0.460,均P<0.05)。低水平PLT、高水平MPV、低水平miR-4731-5p、高水平MSLN是需治疗ITP发生的独立危险因素(均P<0.05)。血清miR-4731-5p、MSLN联合预测的AUC大于单项预测(均P<0.05)。结论:ITP患者血清miR-4731-5p水平降低,MSLN水平升高,两者与血常规指标密切相关,对需治疗ITP的发生有较高预测价值。

Objective:To explore the correlation between serum microRNA-4731-5p(miR-4731-5p),mesothelin(MSLN)levels and the occurrence of primary immune thrombocytopenia(ITP)requiring treatment.Methods:A total of 118 ITP patients were selected and divided into treatment group(62 cases)and observation group(56 cases)according to platelet(PLT)count and whether they were accompanied by bleeding.Sixty healthy subjects were selected as control group.White blood cell count,hemoglobin,PLT and mean platelet volume(MPV)were measured by automatic blood analyzer.Real-time fluorescence quantitative PCR and enzyme-linked immunosorbent assay were used to determine serum miR-4731-5p and MSLN levels,respectively.The blood routine,serum miR-4731-5p and MSLN levels of the three groups were compared.The correlation between serum miR-4731-5p,MSLN,PLT and MPV in ITP patients,the factors affecting the occurrence of ITP requiring treatment,and the predictive value of serum miR-4731-5p and MSLN for the occurrence of ITP requiring treatment were analyzed.Results:The levels of PLT and serum miR-4731-5p in control group,observation group and treatment group were decreased successively,while the levels of MPV and serum MSLN were increased successively(all P<0.05).The serum miR-4731-5p was negatively correlated with MSLN in ITP patients(r=-0.683,P<0.05);miR-4731-5p was positively correlated with PLT and negatively correlated with MPV(r=0.401、-0.564,all P<0.05);MSLN was negatively correlated with PLT and positively correlated with MPV(r=-0.429、0.460,all P<0.05).Low level of PLT,high level of MPV,low level of miR-4731-5p and high level of MSLN were independent risk factors that affected the occurrence of treatable ITP(all P<0.05).The AUC of combined prediction of serum miR-4731-5p and MSLN was greater than that of single prediction(all P<0.05).Conclusion:Serum miR-4731-5p levels were decreased and MSLN levels were increased in ITP patients,both of which were closely related to blood routine indexes and had high predictive efficacy for the occurrence of ITP requiring treatment.