微小RNA-155和白细胞介素-6在子痫前期极早产新生儿中表达水平的差异及临床意义

Differences in expression levels of microRNA-155 and interleukin-6 in very preterm neonates with preeclampsia and their clinical significance

目的观察微小RNA-155(miR-155)mRNA和白细胞介素-6(IL-6)在子痫前期极早产新生儿中表达水平的差异及临床意义。方法选择2021年1月至12月聊城市人民医院产科收治的28例子痫前期孕母分娩极早产新生儿〔胎龄<32周和(或)体质量<1500 g〕作为观察组,以同期本院住院治疗其他原因导致的极早产儿26例作为对照组。收集患儿相关电子病历临床资料,包括极早产儿和孕母一般情况(性别、胎龄、出生体质量、有无子痫前期等)、有创通气比例、支气管肺发育不良(BPD)比例、急性呼吸窘迫综合征(ARDS)和早发脓毒症发生率、白细胞计数(WBC)、中性粒细胞计数(NEUT),以及出生后脐动脉血清中miR-155 mRNA表达、IL-6水平,并比较两组上述指标的差异。采用Pearson相关性分析法分析miR-155、IL-6水平的相关性。结果观察组出生体质量明显低于对照组(kg:1.21±0.22比1.32±0.33,P<0.05),有创通气、BPD、ARDS比例和脓毒症发生率均明显高于对照组〔有创通气比例:75.0%(21/28)比57.7%(15/26),BPD比例:35.7%(10/28)比11.5%(3/26),ARDS发生率:100.0%(28/28)比84.6%(22/26),脓毒症发生率:71.4%(20/28)比53.8%(14/26),均P<0.05〕,miR-155 mRNA表达和IL-6水平均明显高于对照组〔miR-155 mRNA(2-ΔΔCt):0.93±0.18比0.17±0.03,IL-6(ng/L):73.84(33.44,429.00)比19.05(9.30,47.20),均P<0.05〕。Pearson相关性分析显示:miR-155和IL-6水平呈明显正相关(r=0.782,P<0.01)。两组随出生时间延长,WBC和NEUT均逐渐降低,观察组出生后各时间点WBC和NEUT比较差异均有统计学意义,出生后48 h和72 h均明显低于出生后24 h(均P<0.05)。观察组出生后24、48和72 h WBC均明显低于对照组(×109/L:出生后24 h为7.85±2.44比12.28±6.81,出生后48 h为7.31±3.53比10.98±7.91,出生后72 h为4.97±2.05比7.82±4.65,均P<0.05),NEUT仅出生后24 h和48 h两个时间点观察组明显低于对照组(×109/L:出生后24 h为4.13±1.93比7.45±5.67,出生后48 h为3.96±2.64比6.89±6.24,均P<0.05)。结论子痫前期极早产新生儿出生时机体内miR-155 mRNA表达、IL-6水平明显上调,机体炎症反应紊乱,对早期评估病情有一定价值。

Objective To observe the difference and clinical significance of expression levels of microRNA-155(miR-155)mRNA and interleukin-6(IL-6)in very preterm neonates with preeclampsia.Methods Twenty-eight cases of very preterm newborns(gestational age<32 weeks and/or body weight<1500 g)from preeclampsia pregnant women admitted to the department of obstetrics of Liaocheng People's Hospital from January to December 2021 were selected as the observation group,and 26 cases of very preterm neonates hospitalized for other reasons during the same period were selected as the control group.Electronic medical record clinical data related to children were collected,and the differences between the two groups were compared,including general conditions of preterm infants and pregnant mothers(gender,gestational age,birth weight,preeclampsia or not),proportion of invasive ventilation,proportion of bronchopulmonary dysplasia(BPD),incidence of acute respiratory distress syndrome(ARDS)and early-onset sepsis,white blood cell count(WBC),neutrophil count(NEUT),and expression of miR-155 mRNA and IL-6 levels in the serum of umbilical arterial blood after birth.Pearson correlation analysis was used to analyze the correlation between miR-155 and IL-6 levels Results The birth body weight of the observation group was significantly lower than that of the control group(kg:1.21±0.22 vs.1.32±0.33,P<0.05),the proportion of invasive ventilation,the proportion of BPD,the incidence of ARDS and sepsis were significantly higher than those in the control group[the proportion of invasive ventilation:75.0%(21/28)vs.57.7%(15/26),the proportion of BPD:35.7%(10/28)vs.11.5%(3/26),incidence of ARDS:100.0%(28/28)vs.84.6%(22/26),incidence of sepsis:71.4%(20/28)vs.53.8%(14/26),all P<0.05],the level of miR-155 mRNA expression and IL-6 were significantly higher than those in the control group[miR-155 mRNA(2-ΔΔCt):0.93±0.18 vs.0.17±0.03,IL-6(ng/L):73.84(33.44,429.00)vs.19.05(9.30,47.20),both P<0.05].Pearson correlation analysis showed that miR-155 and IL-6 levels were significantly positively correlated(r=0.782,P<0.01).With the extension of birth time,both WBC and NEUT gradually decreased in the two groups,and there were statistically significant differences in WBC and NEUT at each time point after birth,with counts significantly lower at 48 hours and 72 hours compared to 24 hours after birth(both P<0.05).The WBC of the observation group at 24,48 and 72 hours after birth was significantly lower than that of the control group(×109/L:7.85±2.44 vs.12.28±6.81 at 24 hours after birth,7.31±3.53 vs.10.98±7.91 at 48 hours after birth,4.97±2.05 vs.7.82±4.65 at 72 hours after birth,all P<0.05),NEUT in observation group was significantly lower than of control group at 24 hours and 48 hours after birth(×109/L:24 hours after birth was 4.13±1.93 vs.7.45±5.67,48 hours after birth was 3.96±2.64 vs.6.89±6.24,both P<0.05).Conclusion The expression level of miR-155 mRNA and IL-6 in very preterm neonates with preeclampsia is significantly up-regulated at the time of birth,and the inflammatory response of the body is disturbed,which has certain value for early assessment of the disease.