外周血miR-155水平对免疫球蛋白治疗川崎病患儿临床疗效的预测价值

Analysis of the Predictive Value of Peripheral Blood miR-155 Levels for the Clinical Efficacy of Immunoglobulin Therapy in Children with Kawasaki Disease

【目的】探讨外周血miR-155水平对免疫球蛋白治疗川崎病(KD)患儿临床疗效的预测价值。【方法】选取2018年10月至2021年3月本院收治的187例KD患儿为研究对象,根据治疗后14 d内临床疗效将其分为敏感组(n=162)和无反应组(n=25)。分析影响KD患儿临床疗效的因素,分析治疗前外周血miR-155相对表达量对KD患儿免疫球蛋白治疗临床疗效的预测价值。【结果】187例KD患儿经治疗后有25例(13.37%)出现免疫球蛋白无反应情况。无反应组丙氨酸转氨酶、天冬氨酸氨基转移酶、γ-谷氨酰转肽酶、总胆红素、超敏C反应蛋白、红细胞沉降率、肌钙蛋白I、氨基末端脑钠肽前体(NT-proBNP)及miR-155相对表达量均高于敏感组(P<0.05)。Logistic回归分析显示,miR-155相对表达量、NT-proBNP是影响KD患儿免疫球蛋白治疗临床疗效的相关因素(P<0.05)。ROC曲线分析显示,外周血miR-155相对表达量评估KD患儿免疫球蛋白治疗的临床疗效的最佳截断值、灵敏度、特异度、曲线下面积分别为3.01、76.00%、80.25%、0.785(P<0.05)。【结论】KD患儿免疫球蛋白无反应发生风险高,miR-155与KD患儿免疫球蛋白治疗临床疗效有关,miR-155预测KD患儿免疫球蛋白治疗临床疗效的效能较高。

【Objective】To explore the predictive value of peripheral blood miR-155 levels for the clinical efficacy of immunoglobulin therapy in children with Kawasaki disease.【Methods】A total of 187 children with KD admitted to the hospital from October 2018 to March 2021 were selected as the study subjects.They were divided into a sensitive group(n=162)and a non responsive group(n=25)based on their clinical efficacy within 14 days after treatment.The factors affecting the clinical efficacy of KD children were analyzed,and the predictive value of the relative expression level of miR-155 in peripheral blood before treatment on the clinical efficacy of immunoglobulin therapy in KD children was analyzed.【Results】After treatment,25 out of 187 children with KD(13.37%)showed no response to immunoglobulin.Non reactive group alanine aminotransferase,aspartate aminotransferase,γ-glutamyl transpeptidase,total bilirubin,the relative expression levels of hypersensitive C-reactive protein,erythrocyte sedimentation rate,troponin I,N-terminal B-type brain natriuretic peptide(NT-proBNP),and miR-155 were higher in the sensitive group than in the sensitive group(P<0.05).Logistic regression analysis showed that the relative expression level of miR-155 and NT-proBNP were related factors affecting the clinical efficacy of immunoglobulin therapy in children with KD(P<0.05).ROC curve analysis showed that the optimal cutoff point,sensitivity,specificity,and area under the curve for evaluating the clinical efficacy of immunoglobulin therapy in KD children with peripheral blood miR-155 relative expression were 3.01%,76.00%,80.25%,and 0.785,respectively(P<0.05).【Conclusion】Children with KD have a high risk of immunoglobulin non response,and miR-155 is associated with the clinical efficacy of immunoglobulin therapy in KD patients.miR-155 has a higher predictive effect on the clinical efficacy of immunoglobulin therapy in KD patients.