儿童肺炎支原体肺炎外周血miR-217、Th17/Treg水平变化及其与疾病进展的关系

Changes of peripheral blood miR-217 and Th17/Treg of children with Mycoplasma pneumoniae pneumonia and association with disease progression

目的 探讨儿童肺炎支原体肺炎(MPP)外周血微小核糖核酸-217(miR-217)、辅助型T细胞17(Th17)/调节型T细胞(Treg)水平变化及其与疾病进展的关系。方法 选取2021年3月—2023年2月在无锡市第九人民医院就诊的168例MPP患儿纳入病例组,按照病情程度将其分为轻症组112例和重症组56例;另选取同期体检人群中的60名健康儿童纳入对照组。比较各组外周血miR-217、Th17/Treg水平变化;采用Logistic回归分析MPP患儿疾病进展的危险因素;利用受试者工作特征(ROC)曲线分析外周血miR-217、Th17/Treg水平对MMP患儿疾病进展的预测价值。结果 病例组外周血miR-217、Th17/Treg水平均高于对照组(P<0.05)。多因素分析结果显示,高肺炎支原体(MP)抗体滴度、外周血miR-217、Th17/Treg水平高是影响MPP患儿疾病进展的危险因素(P<0.05)。ROC曲线分析显示,外周血miR-217、Th17/Treg单独检测预测MMP患儿疾病进展的曲线下面积分别为0.990、0.915,两者联合检测的曲线下面积为0.996。结论 MPP患儿外周血miR-217、Th17/Treg水平均升高,且外周血miR-217、Th17/Treg是影响MPP患儿病情进展的危险因素,联合检测的预测价值更高。

OBJECTIVE To explore the changes of peripheral blood microRNA-217(miR-217)and helper T cell 17(Th17)/regulatory T cell(Treg)of the children with Myco plasma pneumoniae pneumonia(MPP)and ana-lyze the association with disease progression.METHODS A total of 168 children with MPP who were treated in Wuxi Ninth People's Hospital Affiliated to Soochow University from Mar 2021 to Feb 2023 were recruited as the case group and were divided into the mild group with 112 cases and the severe group with 56 cases according to the illness condition,meanwhile,60 healthy children who received physical examination were chosen as the control group.The levels of peripheral blood miR-217 and Th17/Treg were compared among the groups.Logistic regres-sion analysis was performed for the risk factors for the disease progression of the MPP children.The values of the peripheral blood miR-217 and Th17/Treg in prediction of the disease progress were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The levels of peripheral blood miR-217 and Th17/Treg of the case group were higher than those of the control group(P<0.05).The result of multivariate analysis showed that high antibody titer of M.pneumoniae and high levels of peripheral blood miR-217 and Th17/Treg were the risk factors for the disease progression of the MPP children(P<0.05).ROC curve analysis showed that the areas un-der curves of the peripheral blood miR-217 and Th17/Treg were respectively 0.990 and 0.915 in prediction of the disease progression of the MPP children,and the area under curve of the joint detection was 0.996.CONCLUSION The levels of peripheral blood miR-217 and Th17/Treg of the MPP children are elevated,and the peripheral blood miR-217 and Th17/Treg are the risk factors for the disease progression of the MPP children.The joint detection of the indexes has higher predictive value.