川崎病合并肺炎支原体感染儿童外周血miR-1323、IL-6/STAT3通路表达水平

Peripheral blood miR-1323 and IL-6/STAT 3 pathway expression levels in children with Kawasaki disease complicated with Mycoplasma pneumoniae infection

目的探究川崎病合并肺炎支原体(MP)感染儿童外周血微小RNA-1323(miR-1323)及白细胞介素(IL)-6/信号传导与转录激活因子3(STAT3)通路表达水平。方法选择杭州市儿童医院2020年1月-2023年12月收治的98例川崎病合并MP感染患儿为MP感染组,另选择同期60例未并发MP的川崎病患儿为非感染组;统计分析两组miR-1323、IL-6、STAT3 mRNA水平;同时根据心脏彩超结果将川崎病合并MP感染患儿分为冠状动脉损伤(CAL)组和非CAL组,采用Logistic回归分析川崎病合并MP感染患儿发生CAL的危险因素;受试者工作特征(ROC)曲线评估外周血miR-1323、IL-6/STAT3通路预测川崎病合并MP感染患儿发生CAL的效能。结果MP感染组miR-1323、IL-6、STAT3 mRNA水平高于非感染组(P<0.05);CAL组miR-1323、IL-6、STAT3 mRNA、IL-1β、C-反应蛋白(CRP)、干扰素-γ(IFN-γ)、血小板计数(PLT)均高于非CAL组(P<0.05),IL-10低于非CAL组(P<0.05);发热持续时间、住院时间均长于非CAL组(P<0.05);存在呼吸系统症状占比高于非CAL组(P<0.05);miR-1323、IL-6和STAT3mRNA是川崎病并发MP感染患儿CAL发生的危险因素(P<0.05);miR-1323联合IL-6/STAT3通路水平预测川崎病合并MP感染患儿CAL发生的曲线下面积大于单独检测。结论川崎病并发MP感染患儿外周血miR-1323、IL-6/STAT3通路水平升高,且均是川崎病并发MP感染患儿发生CAL的危险因素,有望成为川崎病并发MP感染患儿临床诊疗的潜在指标。

OBJECTIVE To investigate the expression levels of peripheral microRNA-1323(miR-1323)and inter-leukin(IL)-6/signal transducer and activator of transcription 3(STAT3)pathway in children with Kawasaki disease complicated with Mycoplasma pneumoniae(MP)infection.METHODS A total of 98 children with Kawasaki disease complicated with MP infection in Hangzhou Children's Hospital from January 2020 to December 2023 were selected as the MP infection group,and 60 children with Kawasaki disease without MP infection during the same period were selected as the non-infection group.The levels of miR-1323,IL-6 and STAT3 mRNA in the two groups were statistically analyzed.At the same time,children with Kawasaki disease complicated with MP infection were divided into coronary artery injury(CAL)group and non-CAL group according to the results of echo-cardiography.Logistic regression was used to analyze the risk factors of CAL in children with Kawasaki disease complicated with MP infection.The receiver operating characteristic(ROC)curve was used to evaluate the efficacy of peripheral miR-1323 and IL-6/STAT3 pathway expression in predicting the occurrence of CAL in children with Kawasaki disease complicated with MP infection.RESULTS The levels of miR-1323,IL-6 and STAT3 mRNA in the MP infection group were significantly higher than those in the non-infection group(P<o.05).Peripheral miR-1323,IL-6,STAT3 mRNA,IL-1β,C-reactive protein(CRP),interferon-γ(IFN-γ)and platelet count(PLT)in the CAL group were higher than those in the non-CAL group(P<0.05),while the IL-10 was lower than that in the non-CAL group(P<o.05).The duration of fever and hospitalization time were longer than those in the non-CAL group(P<0.05).The proportion of patients with respiratory symptoms was higher than that in the non-CAL group(P<0.05).Logistic regression analysis showed that miR-1323,IL-6 and STAT3 mRNA were the independent risk factors for CAL in children with Kawasaki disease complicated with MP infection(P<0.05).The ROC curve showed that the area under the curve of miR-1323 combined with IL-6/STAT3 pathway in predicting the occurrence of CAL in children with Kawasaki disease complicated with MP infection was higher than those single test.CONCLUSION The levels of miR-1323 and IL-6/STAT3 pathway in peripheral blcod of children with Kawasaki disease complicated with MP infection were significantly increased,which were the risk factors for CAL in children with Kawasaki disease complicated with MP infection,and might be potential indicators for clinical diagnosis and treatment of children with Kawasaki disease complicated with MP infection.