摘要
目的探究血清微小核糖核酸155-5p(miR-155-5p)联合微小核糖核酸-126(miR-126)评估急性呼吸窘迫综合征(ARDS)患儿病情严重程度价值。方法本研究为回顾性队列研究,选取2017年5月至2020年11月枣庄市妇幼保健院PICU收治的114例ARDS患儿为ARDS组,男54例,女60例,年龄(6.23±1.05)岁,年龄范围为4~8岁。根据氧合指数将患儿分为轻度组(n=38)、中度组(n=44)及重度组(n=32)。同时选取112名同期健康体检小儿为健康组,男55名,女57名,年龄(6.19±1.11)岁,年龄范围为4~8岁。比较四组纳入小儿的血清miR-155-5p和miR-126及PaO_(2)/FiO_(2)值。对miR-155-5p与miR-126与ARDS组患儿氧合指数进行相关性分析,同时绘制受试者工作特征(ROC)曲线分析miR-155-5p与miR-126对于ARDS组患儿病情严重程度的预测价值。结果轻度组、中度组和重度组患儿血清miR-155-5p与miR-126水平显著高于健康组,PaO_(2)/FiO_(2)值显著低于健康组,差异有统计学意义(P<0.05)。中度组和重度组患儿血清miR-155-5p和miR-126水平显著高于轻度组,动脉血氧分压(PaO_(2))/吸入氧浓度(FiO_(2))值显著低于轻度组,差异有统计学意义(P<0.05);重度组患儿血清miR-155-5p和miR-126水平显著高于中度组,PaO_(2)/FiO_(2)值显著低于中度组,差异有统计学意义(P<0.05)。miR-155-5p与miR-126均与患儿PaO_(2)/FiO_(2)呈负相关,差异有统计学意义(P<0.05)。miR-155-5p预测患儿病情严重程度灵敏度为78.9%,特异度为83.9%;miR-126预测患儿病情严重程度灵敏度为66.7%,特异度为86.6%;两者联合检测灵敏度为96.5%,特异度为94.2%。miR-155-5p联合miR-126诊断ARDS灵敏度、特异度均显著高于单一检测,差异有统计学意义(P<0.05)。结论血清miR-155-5p、miR-126在ARDS的发生和发展中发挥着重要的作用,与患儿严重程度存在明显的相关性,两者联合检测可有效提高预测灵敏度和特异度。
Objective To explore the value of serum miR-155-5p(miR-155-5p)and miR-126(miR-126)in evaluating the severity of acute respiratory distress syndrome(ARDS)in children.Methods This study was a retrospective cohort study,a total of 114 children with ARDS admitted to the PICU of Zaozhuang Maternal and Child Health Hospital from May 2017 to November 2020 were selected as the ARDS group,54 males and 60 females,aged(6.23±1.05)years old,ranging from 4 to 8 years old.The children were divided into mild group(n=38),moderate group(n=44)and severe group(n=32)according to oxygenation index.At the same time,112 children undergoing physical examination at the same time were selected as the healthy group,55 males and 57 females,aged(6.19±1.11)years old,ranging from 4 to 8 years old.The serum miR-155-5p,miR-126 and PaO_(2)/FiO_(2)values of the four groups of children were compared.The correlation between miR-155-5p,miR-126 and oxygenation index of children in the ARDS group was analyzed.At the same time,the ROC curve of subjects was drawn to analyze the predictive value of miR-155-5p and miR-126 for the severity of the disease in children in the ARDS group.Results The levels of serum miR-155-5p and miR-126 in mild group,moderate group and severe group were higher than those in healthy group,and the PaO_(2)/FiO_(2)values were lower than those in healthy group,the differences were statistically significant(P<0.05).The serum miR-155-5p and miR-126 levels in the moderate and severe groups were significantly higher than those in the mild group,and PaO_(2)/FiO_(2)values were significantly lower than those in the mild group,with a statistically significant difference(P<0.05).The serum miR-155-5p and miR-126 levels in severe group were significantly higher than those in moderate group,and PaO_(2)/FiO_(2)values were significantly lower than those in moderate group,with statistical significance(P<0.05).MiR-155-5p and miR-126 were negatively correlated with PaO_(2)/FiO_(2)in children,and the difference was statistically significant(P<0.05).The sensitivity and specificity of miR-155-5p were 78.9%and 83.9%respectively in predicting the severity of the disease,the sensitivity and specificity of miR-126 were 66.7%and 86.6%respectively,the sensitivity and specificity of the two methods were 96.5%and 94.2%respectively,the sensitivity and specificity of miR-155-5p combined with miR-126 in the diagnosis of ARDS were significantly higher than those of a single test,the differences were statistically significant(P<0.05).Conclusions Serum miR-155-5p and miR-126 play an important role in the occurrence and development of ARDS,and have obvious correlation with the severity of children.The combined detection of miR-155-5p and miR-126 can effectively improve the prediction sensitivity and specificity.
作者
战薇
倪扬扬
孙莉莉
丁倩
张淼
Zhan Wei;Ni Yangyang;Sun Lili;Ding Qian;Zhang Miao(Department of Intensive Care Unit,Zaozhuang Maternal and Child Health Hospital,Zaozhuang 277100,China;Department of Chinese Medicine Pediatrics,National Children′s Medical Center/Beijing Children′s Hospital affiliated to Capital Medical University Pediatrics of Traditional Chinese Medicine,Beijing 100045,China)
出处
《中国临床实用医学》
2022年第6期11-15,共5页
China Clinical Practical Medicine
基金
北京中医药科技发展资金项目(QN2015-20)。
作者简介
通信作者:张淼,Email:13811295361@163.com。
