摘要
目的探讨缺氧缺血性脑病(HIE)早产儿血清微小RNA-181b(miR-181b)、Toll样受体4(TLR4)表达水平及与预后的关系。方法选取2018年12月至2021年3月在邯郸市中心医院新生儿科接受治疗的HIE早产儿105例作为HIE组,另选取同期在本院出生的正常早产儿80例作为对照组;根据HIE早产儿病情程度分为:轻度29例(轻度组)、中度44例(中度组)、重度32例(重度组),并根据治疗后好转情况将HIE早产儿分为死亡组(早产儿死亡)22例和生存组(治疗好转出院)83例。采用实时荧光定量PCR和酶联免疫吸附法分别检测血清miR-181b、TLR4表达水平,采用Pearson检验分析HIE早产儿血清miR-181b与TLR4表达水平的相关性,采用受试者工作特征曲线分析血清miR-181b、TLR4表达水平对HIE早产儿生存的预测价值,并分析血清miR-181b、TLR4表达水平与HIE早产儿生存的关系。结果HIE组早产儿血清miR-181b表达水平明显低于对照组(P<0.05),血清TLR4表达水平明显高于对照组(P<0.05);轻度组、中度组、重度组HIE早产儿血清miR-181b表达水平依次降低(P<0.05),血清TLR4表达水平依次升高(P<0.05);HIE早产儿血清miR-181b与TLR4表达水平呈负相关(P<0.05);死亡组早产儿血清miR-181b表达水平明显低于生存组(P<0.05),血清TLR4表达水平明显高于生存组(P<0.05);血清miR-181b、TLR4表达水平预测HIE早产儿生存的曲线下面积分别为0.849(95%CI:0.776~0.923)、0.898(95%CI:0.837~0.960);高miR-181b表达组的生存率明显高于低miR-181b表达组(P<0.05),低TLR4表达组的生存率明显高于高TLR4表达组(P<0.05)。结论HIE早产儿血清miR-181b表达下调,TLR4表达上调,二者均与HIE发生、发展有关,对HIE早产儿预后生存有一定的预测价值。
Objective To investigate the expression levels of serum microRNA-181b(miR-181b)and Toll-like receptors 4(TLR4)in premature infants with hypoxic-ischemic encephalopathy(HIE)and their relationship with prognosis.Methods From December 2018 to March 2021,105 premature infants with HIE who were treated in department of neonates,Handan Central Hospital were selected as the HIE group,and 80 normal premature infants born in this hospital during the same period as the control group.According to the severity of HIE,premature infants were divided into mild 29 cases(mild group),moderate 44 cases(moderate group)and severe 32 cases(severe group).According to the improvement after treatment,HIE preterm infants were divided into 22 cases in the death group(premature death)and 83 cases in the survival group(treatment improved and discharged).Real-time fluorescent quantitative PCR and enzyme-linked immunosorbent assay were used to detect the expression level of serum miR-181b and TLR4.Pearson test was used to analyze the correlation between serum miR-181b and TLR4 expression levels in HIE preterm infants.The receiver operating characteristic curve was used to analyze the predictive value of serum miR-181b and TLR4 expression levels for the survival of premature infants with HIE.The relationship between the expression levels of serum miR-181b and TLR4 and the survival of preterm infants with HIE was analyzed.Results The expression level of serum miR-181b in the HIE group was significantly lower than that in the control group(P<0.05),and the expression level of serum TLR4 was significantly higher than that in the control group(P<0.05).The expression level of serum miR-181b decreased in mild group,moderate group and severe group(P<0.05),and the expression level of serum TLR4 increased in turn(P<0.05).Serum miR-181b and TLR4 expression levels in HIE premature infants were negatively correlated(P<0.05).The expression level of serum miR-181b in the death group was significantly lower than that in the survival group(P<0.05),and the expression level of serum TLR4 was significantly higher than that in the survival group(P<0.05).The area under the curve of serum miR-181b and TLR4 expression levels predicting survival of premature infants with HIE was 0.849(95%CI:0.776-0.923)and 0.898(95%CI:0.837-0.960),respectively.The survival rate of the high miR-181b expression group was significantly higher than that of the low miR-181b expression group(P<0.05),and the survival rate of the low TLR4 expression group was significantly higher than that of the high TLR4 expression group(P<0.05).Conclusion The expression of serum miR-181b in premature infants with HIE is down-regulated,and the expression of TLR4 is up-regulated,both of which are related to the occurrence and development of HIE,which had a certain predictive value for the prognosis survival of HIE preterm infants.
作者
张晓丽
闫丽娟
翟丽娜
翟淑芬
平莉莉
ZHANG Xiaoli;YAN Lijuan;ZHAI Lina;ZHAI Shufen;PING Lili(Department of Neonates, Handan Central Hospital, Handan 056000, China)
出处
《标记免疫分析与临床》
CAS
2021年第12期2083-2087,共5页
Labeled Immunoassays and Clinical Medicine
基金
河北省医学科学研究重点课题计划项目(编号:20180803)
河北省重点研发计划项目(编号:182777236)。
