肺炎支原体肺炎患儿外周血miR-106a、miR-20a表达与胸部X线表现及炎症的相关性-东南大学学报医学版

肺炎支原体肺炎患儿外周血miR-106a、miR-20a表达与胸部X线表现及炎症的相关性

单位：衡水市人民医院小儿内科, 河北衡水 053000

分类号：R725.6

出版年·卷·期（页码）：2024·43·第一期（25-33）

摘要：

目的: 探讨肺炎支原体肺炎(MPP)患儿外周血微小RNA(miR)-106a、miR-20a表达与胸部X线(CXR)表现及炎症的相关性。方法: 选取2020年1月至2021年12月本院收治的393例MPP患儿作为研究对象。采用全自动血细胞分析仪检测白细胞计数、红细胞计数、血小板计数、中性分叶核白细胞等,免疫透射比浊法检测C反应蛋白(CRP)水平。采用实时定量聚合酶链反应法检测外周血miR-106a和miR-20a表达。所有患儿均在入组后接受CXR检查。结果: MPP患儿外周血miR-106a和miR-20a的表达水平分别为1.00(0.61,2.11)、1.06(0.73,1.67)。根据中位值分组,与miR-106a和miR-20a低表达组相比,高表达组患儿CRP水平和肺实变患儿比例明显更高(P<0.05);miR-20a高表达组患儿胸腔积液患儿比例也显著高于低表达组(P<0.05)。MPP患儿外周血miR-106a和miR-20a与CRP呈显著正相关(r值分别为0.212、0.230,均P<0.001)。肺实变组外周血miR-106a和miR-20a表达水平均显著高于非肺实变组(P<0.05)。经ROC曲线分析,外周血miR-106a和miR-20a预测MPP肺实变的曲线下面积(AUC)为0.811(95%CI: 0.767~0.855)、0.807(95%CI: 0.762~0.852),灵敏度分别为75.3%和77.4%,特异度分别为76.5%和76.4%,对应的截断值为1.20和1.18。Logistic回归分析显示,外周血miR-106a和miR-20a高表达是MPP肺实变的独立影响因素(P<0.05)。结论: MPP患儿外周血miR-106a和miR-20a过表达与CXR严重表现和炎症加重有关,两者可作为指示MPP严重程度和炎症进展的标志物。

Objective: To investigate the correlation between peripheral blood microrna(miR)-106a and miR-20a expression and chest X-ray(CXR) manifestations and inflammation in children with Mycoplasma pneumoniae pneumonia(MPP). Methods: 393 children with MPP admitted to our hospital from January 2020 to December 2021 were selected as research objects. White blood cell count,red blood cell count,platelet count and neutral lobed nucleus leukocyte were measured by automatic blood cell analyzer,and C-reactive protein(CRP) was detected by immunoturbidimetry. The expression of miR-106a and miR-20a in peripheral blood was detected by real-time quantitative polymerase chain reaction. All patients underwent CXR examination after enrollment. Results: The expression levels of miR-106a and miR-20a in peripheral blood of MPP patients were 1.00(0.61,2.11) and 1.06(0.73,1.67),respectively. After grouping based on median values,compared with miR-106a and miR-20a low expression groups,the level of CRP and the proportion of lung consolidation patients in the high expression group were significantly higher(P<0.05). Moreover,the proportion of children with pleural effusion in the high expression group of miR-20a was significantly higher than that in the low expression group(P<0.05). There was a significant positive correlation between peripheral blood miR-106a and miR-20a in MPP patients and CRP(r=0.212,0.230,P<0.001). The expression levels of miR-106a and miR-20a in peripheral blood of the lung consolidation group were significantly higher than those of the non lung consolidation group(P<0.05). According to ROC curve analysis,the area under the curve(AUC) of peripheral blood miR-106a and miR-20a for predicting MPP lung consolidation were 0.811(95%CI:0.767-0.855) and 0.807(95%CI:0.762-0.852),with a sensitivity of 75.3% and 77.4%,a specificity of 76.5% and 76.4%,and corresponding cutoff values of 1.20 and 1.18,respectively. Logistic regression analysis showed that high expression of miR-106a and miR-20a in peripheral blood was an independent influencing factor for MPP pulmonary consolidation(P<0.05).Conclusion: The overexpression of miR-106a and miR-20a in peripheral blood of children with MPP is associated with severe CXR manifestations and increased inflammation,which may be used as markers to indicate the severity of MPP and the progression of inflammation.

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