复发性口腔溃疡患儿血清IRF5、sTREM-1变化及对复发的预测价值

Changes in serum IRF5 and sTREM-1 levels in children with recurrent oral ulcers and their predictive value for recurrence

目的探讨复发性口腔溃疡患儿血清干扰素调节因子5(IRF5)、可溶性髓样细胞触发受体1(sTREM-1)水平变化及其对复发的预测价值。方法选取石家庄市妇幼保健院于2021年7月至2022年12月收治的146例复发性口腔溃疡患儿为观察组,并根据3个月内是否复发分为复发组(n=45)和未复发组(n=101)。另选取同期138例健康志愿者作为对照组。采用实时荧光定量PCR(qPCR)检测血清IRF5 mRNA表达水平,酶联免疫吸附试验(ELISA)检测血清sTREM-1、白细胞介素(IL)-6和IL-10表达水平,Pearson分析法分析复发性口腔溃疡患儿血清IRF5和sTREM-1水平与IL-6和IL-10水平的相关性,受试者工作特征(ROC)曲线分析血清IRF5和sTREM-1水平对复发性口腔溃疡患儿复发的预测价值。结果与对照组比较,观察组血清IRF5水平明显降低(P<0.05),sTREM-1、IL-6和IL-10水平明显升高(P<0.05);Pearson分析结果显示,复发性口腔溃疡患儿血清IRF5与IL-6、IL-10水平呈负相关(r=-0.531、-0.462,P<0.05),血清sTREM-1水平与IL-6、IL-10水平呈正相关(r=0.435、0.480,P<0.05);与未复发组比较,复发组患儿血清IRF5水平明显降低(P<0.05),sTREM-1水平明显升高(P<0.05)。ROC曲线分析结果显示,血清IRF5水平单独预测复发性口腔溃疡患儿复发的曲线下面积(AUC)为0.823,最佳cut-off值为0.85,灵敏度和特异度分别为75.56%、84.16%;血清sTREM-1水平单独预测复发性口腔溃疡患儿复发的AUC为0.833,灵敏度和特异度分别为68.89%、88.12%,最佳cut-off值为84.08 pg/mL;二者联合预测复发性口腔溃疡患儿复发的灵敏度和特异度分别为88.89%、82.18%,AUC为0.915,显著高于IRF5单独预测的AUC(Z=2.455,P=0.014)和sTREM-1单独预测的AUC(Z=2.790,P=0.005)。结论复发性口腔溃疡患儿血清IRF5水平较低、sTREM-1水平较高,二者联合对复发性口腔溃疡患儿再复发具有较高的预测价值。

Objective To investigate the changes of serum interferon regulatory factor 5(IRF5)and soluble triggering receptor expressed on myeloid cells 1(sTREM-1)in children with recurrent oral ulcers and their predictive value for recurrence.Methods A total of 146 children with recurrent oral ulcers treated in Shijiazhuang Maternal and Child Healthcare Hospital from July 2021 to December 2022 were collected as the observation group,and were grouped into a recurrent group(n=45)and a non-recurrent group(n=101)according to whether the disease recurred within 3 months.Another 138 healthy volunteers in the same period were regarded as the control group.Real-time fluorescence quantitative PCR(qPCR)was applied to detect the expression level of serum IRF5 mRNA expression levels,and enzyme-linked immunosorbent assay(ELISA)was used to detect serum sTREM-1,interleukin(IL)-6 and IL-10 expression levels.Pearson analysis was applied to analyze the correlation between serum IRF5 and sTREM-1 levels and IL-6 and IL-10 levels in children with recurrent oral ulcers.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum IRF5 and sTREM-1 levels for recurrence in children with recurrent oral ulcers.Results Compared with the control group,the serum IRF5 level in the observation group was significantly lower(P<0.05),while the levels of sTREM-1,IL-6,and IL-10 were significantly higher(P<0.05).Pearson analysis results showed that there was a negative correlation between serum IRF5 and IL-6,IL-10 levels in children with recurrent oral ulcers(r=-0.531,-0.462,P<0.05),while serum sTREM-1 level was positively correlated with IL-6,IL-10 levels(r=0.435,0.480,P<0.05).Compared with the non-recurrence group,the serum IRF5 level in the recurrence group was significantly reduced(P<0.05),while the sTREM-1 level was significantly increased(P<0.05).ROC analysis results showed that the area under the curve(AUC)of the serum IRF5 level alone in predicting recurrence in children with recurrent oral ulcers was 0.823,with an optimal cutoff value of 0.85,sensitivity and specificity of 75.56%and 84.16%,respectively;the AUC of the serum sTREM-1 level alone in predicting recurrence in children with recurrent oral ulcers was 0.833,with sensitivity and specificity of 68.89%and 88.12%,respectively,and a optimal cut-off value of 84.08 pg/mL.The sensitivity and specificity of the combination of the two were 88.89%and 82.18%,and the AUC was 0.915,which was significantly higher than that predicted by IRF5 alone(Z=2.455,P=0.014)and sTREM-1 alone(Z=2.790,P=0.005).Conclusion The serum IRF5 level in children with recurrent oral ulcers is lower,the sTREM-1 level is higher,and the combination of the two has high predictive value for the recurrence of recurrent oral ulcers in children.