哮喘儿童血清外泌体中miR-7-5p表达水平与短期预后的相关性研究

Study on the Correlation between Serum Exosomal miR-7-5p Levels and Short-Term Prognostic Outcomes in Children with Asthma

目的 分析哮喘儿童血清外泌体中微小RNA(microRNA,miR)-7-5p表达水平与短期预后的关系。方法 选取2021年10月~2023年5月唐山职业技术学院附属医院的132例哮喘儿童(哮喘组)和30例健康儿童(对照组)作为研究对象。根据儿童哮喘控制测试结果将哮喘儿童分为预后不良组(n=41)和预后良好组(n=91)。比较各组的过敏史、用力肺活量(forced vital capacity,FVC)、呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)和血清外泌体miR-7-5p等水平。用Logistic回归分析哮喘儿童短期预后的风险因素。用Kappa检验、受试者工作特征(receiver operating characteristic,ROC)曲线和平均绝对误差(mean absolute error,MAE)值评价各指标判断哮喘儿童短期预后的价值。结果 哮喘组血清外泌体miR-7-5p[0.53(0.49,0.64)]水平低于对照组[1.03(0.97,1.10)],差异具有统计学意义(χ^(2)/Z=8.548,P <0.001)。预后不良组的过敏史占比(68.29%)和FeNO[38(36,41)ppb]水平高于预后良好组[46.15%,35(30,40)ppb],FVC[1.86(1.84,2.05)L]和miR-7-5p[0.47(0.43,0.52)]水平低于预后良好组[1.94(1.87,2.06)L,0.60(0.50,0.68)],差异具有统计学意义(χ2/Z=2.854~6.450,均P <0.05)。多因素Logistic回归分析结果显示,过敏史(OR=3.388,95%CI:1.328~8.643)和高FeNO(OR=1.161,95%CI:1.064~1.267)水平是哮喘儿童短期预后的独立危险因素(P <0.01),高miR-7-5p(OR=0.090,95%CI:0.033~0.248)水平是哮喘儿童短期预后的独立保护因素(P <0.01)。miR-7-5p+过敏史+FeNO判断哮喘儿童短期预后的ROC曲线下面积为0.904,大于miR-7-5p(0.851,Z=2.097,P=0.036)和过敏史+FeNO(0.726,Z=4.239,P <0.001)。miR-7-5p+过敏史+FeNO的Kappa值为0.67,大于mi R-7-5p(0.44)和过敏史+FeNO(0.41);MAE值为0.022,小于miR-7-5p(0.067)和过敏史+FeNO(0.035)。结论 哮喘儿童血清外泌体中miR-7-5p表达水平高与其短期预后良好有关。miR-7-5p,过敏史和FeNO联合对哮喘儿童短期预后评估有一定价值。

Objective To analyze the relationship between serum exosomal microRNA(miR)-7-5p expression levels in children with asthma and their short-term prognosis.Methods A total of 132 asthmatic children(asthma group)and 30 healthy children(control group)from Tangshan Vocational&Technical College Affiliated Hospital between October 2021 and May 2023 were included as study subjects.These asthmatic children were categorized into a good prognosis group(n=91)and a poor prognosis group(n=41)based on their Childhood Asthma Control Test results.The levels of allergy history,forced vital capacity(FVC),fractional exhaled nitric oxide(FeNO),and miR-7-5p level among groups were compared,and logistic regression analysis was conducted to identify risk factors for the short-term prognosis of asthmatic children.The Kappa test,receiver operating characteristic(ROC)curve,and mean absolute error(MAE)value were used to evaluate indicators in predicting short-term prognosis in children with asthma.Results The level of miR-7-5p in the asthma group[0.53(0.49,0.64)]was lower than that in the control group[1.03(0.97,1.10)],with significant difference(Z=8.548,P<0.001).The poor prognosis group exhibited a higher proportion of allergy history(68.29%)and FeNO[38(36,41)ppb]levels,and lower FVC[1.86(1.84,2.05)L]and miR-7-5p levels[0.47(0.43,0.52)]compared to the good prognosis group[46.15%,35(30,40)ppb,1.94(1.87,2.06)L,0.60(0.50,0.68)],and the differences were significant(χ^(2)/Z=2.854~6.450,all P<0.05).Multivariate logistic regression analysis revealed that a history of allergies(OR=3.388,95%CI:1.328~8.643,P=0.011)and high FeNO levels(OR=1.161,95%CI:1.064~1.267,P=0.001)were independent risk factors,while a high level of miR-7-5p(OR=0.090,95%CI:0.033~0.248,P<0.001)was an independent protective factor for the short-term prognosis of asthmatic children.The area under the ROC curve for miR-7-5p+allergy history+FeNO in predicting the short-term prognosis of asthmatic children was 0.851,which was higher than that for miR-7-5p alone(0.851,Z=2.097,P=0.036)and allergy history+FeNO(0.726,Z=4.239,P<0.001).The Kappa value for miR-7-5p+allergy history+FeNO was 0.67,which was higher than miR-7-5p(0.44)and allergy history+FeNO(0.41).The MAE for miR-7-5p+allergy history+FeNO was 0.022,which was lower than miR-7-5p alone(0.067)and the combination of allergy history+FeNO(0.035).Conclusion Elevated level of miR-7-5p in the serum exosomes of asthmatic children is linked to a favorable short-term prognosis.The combination of miR-7-5p,allergy history,and FeNO may have certain value in evaluating the short-term prognosis of asthmatic children.