血清miR-21、S1P与难治性肺炎支原体肺炎患儿并发肝损伤的关系研究

Study on the Relationship between Serum miR-21,S1P and Liver Injury in Children with RefractoryMycoplasma Pneumoniae Pneumonia

目的:探讨血清微小核糖核酸-21(mi R-21)、1-磷酸鞘氨醇(S1P)与难治性肺炎支原体肺炎(RMPP)患儿并发肝损伤的关系。方法:根据丙氨酸氨基转移酶(ALT)水平将270例RMPP患儿分为肝损伤组(≥40 U/L,39例),无肝损伤组(<40 U/L,231例),并将肝损伤患儿分为轻度肝损伤组(40 U/L~<200 U/L,20例)、中度肝损伤组(200 U/L~<400 U/L,13例)和重度肝损伤组(≥400 U/L,6例)。采用实时荧光定量聚合酶链式反应(RT-PCR)检测miR-21水平,酶联免疫吸附法检测S1P水平。通过单因素及多因素Logistic回归分析RMPP患儿并发肝损伤的影响因素。结果:与对照组比较,RMPP组血清miR-21水平升高,S1P水平降低(P<0.05)。无肝损伤组、轻度肝损伤组、中度肝损伤组、重度肝损伤组血清miR-21水平依次升高,S1P水平依次降低(P<0.05)。经单因素及多因素Logistic回归分析显示热程延长、血清CRP水平升高、血清miR-21水平升高为RMPP患儿并发肝损伤的危险因素,血清S1P水平升高为保护因素(P<0.05)。结论:血清miR-21水平升高、S1P水平降低与RMPP患儿并发肝损伤及其程度有关。

Objective:To investigate the relationship between serum microRNA-21(miR-21),sphingosine-1-phosphate(S1P)and liver injury in children with refractory mycoplasma pneumoniae pneumonia(RMPP).Methods:270 children with RMPP were divided into liver injury group(≥40 U/L,39 cases)and non liver injury group(<40 U/L,231 cases)according to the level of alanine aminotransferase(ALT),and children with liver injury were divided into mild liver injury group(40 U/L~<200 U/L,20 cases),moderate liver injury group(200 U/L~<400 U/L,13 cases)and severe liver injury group(≥400 U/L,6 cases).The level of miR-21 was detected by real-time fluorescence quantitative polymerase chain reaction(RT-PCR),and the level of S1P was detected by enzyme-linked immunosorbent assay.The influencing factors of liver injury in children with RMPP were analyzed by univariate and multivariate logistic regression.Results:Compared with control group,the serum miR-21 level in RMPP group was increased,and the S1P level was decreased(P<0.05).The levels of serum miR-21 in non liver injury group,mild liver injury group,moderate liver injury group and severe liver injury group increased in turn,and the levels of S1P decreased in turn(P<0.05).Univariate and multivariate logistic regression analysis showed that prolonged fever,elevated serum CRP level and elevated serum miR-21 level were risk factors for liver injury in children with RMPP,and elevated serum S1P level was a protective factor(P<0.05).Conclusion:The increase of serum miR-21 level and the decrease of S1P level are related to the degree of liver injury in children with RMPP,and serum miR-21 combined with S1P level has a high predictive value for liver injury in children with RMPP.