血清microRNA-23a在阻塞性睡眠呼吸暂停低通气综合征患儿脑损伤中的作用及意义

The role and significance of serum microRNA-23a in brain injury in children with obstructive sleep apnea hypopnea syndrome

目的 探讨血清microRNA-23a在阻塞性睡眠呼吸暂停低通气综合征儿童脑损伤中的作用及意义。方法 收集2019年12月—2021年12月在湖州市中心医院就诊的阻塞性睡眠呼吸暂停低通气综合征儿童62例作为研究对象,根据呼吸暂停低通气指数进行分组,即轻中度组32例、重度组30例,同时期选取正常儿童28例作为对照组。采用定量PCR检测血清microRNA-23a水平,采用ELISA法检测神经元特异性烯醇化酶(NSE)、S100钙化蛋白β(S100β)水平,3组研究对象血清microRNA-23a、NSE及S100β水平差异性,ROC曲线分析microRNA-23a相对表达量预测阻塞性睡眠呼吸暂停低通气综合征儿童脑损伤严重程度。结果 对照组、轻中度组及重度组在腰臀比、颈围及呼吸暂批评家低通气指数(AHI)方面比较差异有统计学意义(P<0.05),组间比较,重度组腰臀比、颈围及AHI水平均更高,其次为轻中度组,对照组最低。重度组microRNA-23a、NSE及S100β水平均显著高于对照组和轻中度组,且轻中度组水平显著高于对照组(P<0.05)。血清microRNA-23a水平与血清NSE、S100β水平均呈正相关性(r=0.533,r=0.518,均P<0.05)。microRNA-23a相对表达量高属于阻塞性睡眠呼吸暂停低通气综合征儿童脑损伤的危险因素(OR=4.711,95%CI:1.322~10.678)。microRNA-23a相对表达量的cut-off值为0.224,AUC为0.828,95%CI:0.771~0.905,标准误为0.035,P<0.05,特异度0.796,灵敏度0.766,约登指数0.562。结论 血清microRNA-23a水平与阻塞性睡眠呼吸暂停低通气综合征儿童脑损伤存在相关性,可能成为阻塞性睡眠呼吸暂停低通气综合征儿童脑损伤风险因子,对患儿脑损伤的具有诊断价值。

Objective To investigate the role and significance of serum microRNA-23a in brain injury in children with obstructive sleep apnea hypopnea syndrome.Methods A total of 62 children with obstructive sleep apnea-hypopnea syndrome who were treated in our hospital from December 2019 to December 2021 were collected as the research subjects,and were divided into groups according to the apnea-hypopnea index,namely,32 cases in the mild to moderate group,32 cases in the severe There were 30 cases in the group,and 28 normal children were selected as the control group during the same period Quantitative PCR was used to detect the level of serum microRNA-23a,and ELISA was used to detect the levels of NSE and S100β.The differences in serum microRNA-23a,NSE and S100βlevels among the three groups of subjects were analyzed by ROC curve analysis.The relative expression of microRNA-23a predicted obstructive sleep apnea Brain injury severity in children with hypoventilation syndrome.Results Comparison of waist-to-hip ratio,neck circumference and AHI in control group,mild-moderate group and severe group(P<0.05)Compared between groups,waist-to-hip ratio,neck circumference and AHI levels of severe group were higher,fllowed by mild The moderate group and the control group were the lowest The levels of microRNA-23a,NSE,and S10Oβin the severe group were significantly higher than those in the control group and the mild-moderate group,and the levels in the mild-moderate group were significantly higher than those in the control group(P<0.05)Serum microRNA-23a levels were positively correlated with serum NSE and S100βlevels(r=0.533,r=0.518,all P<0.05).The high relative expression of microRNA-23a was a risk factor for brain injury in children with obstructive sleep apnea hypopnea syndrome(OR=4.711,95%Cl:1.322-10.678).The cut-off value of the relative expression of microRNA-23a was 0.224,the AUC was 0.828,95%CI:0.771-0.905,the standard error was 0.035,P<0.05,the specificity was 0.796,the sensitivity was 0.766,and the Youden index was 0.562.Conclusion There is a relationship between brain injury in children with obstructive sleep apnea hypopnea syndrome and the level of serum microRNA-23a,which may become a risk factor for brain injury in children with obstructive sleep apnea hypopnea syndrome,and improve the diagnostic value of brain injury in children.