摘要
目的探讨血清lncRNA RPPH1、miR-145-3p对肺炎支原体(MP)感染患儿病情严重程度及预后的预测价值。方法选取2020年6月至2023年5月在该院接受治疗的124例MP感染患儿作为MP感染组,另选取同期在该院进行体检的124例健康儿童作为对照组。依据CURB-65评分系统进行病情严重程度评估,将MP感染患儿分为重度组与轻度组。随访6个月,根据预后情况将患儿分为预后良好组和预后不良组。采用实时荧光定量聚合酶链反应检测血清lncRNA RPPH1、miR-145-3p表达水平。采用Pearson相关分析MP感染患儿血清lncRNA RPPH1表达水平与miR-145-3p表达水平的相关性。绘制受试者工作特征(ROC)曲线分析血清lncRNA RPPH1、miR-145-3p对重度MP感染的预测效能及对MP感染患儿预后不良的预测价值。采用多因素Logistic回归分析MP感染患儿预后不良的影响因素。结果MP感染组患儿血清lncRNA RPPH1表达水平低于对照组,血清miR-145-3p表达水平高于对照组,差异均有统计学意义(P<0.05)。59例患儿纳入重度组,65例患儿纳入轻度组。重度组血清lncRNA RPPH1表达水平低于轻度组,miR-145-3p表达水平高于轻度组,差异均有统计学意义(P<0.05)。TargetScanHuman网址预测结果显示,lncRNA RPPH1与miR-145-3p间存在结合位点。Pearson相关分析结果显示,MP感染患儿血清lncRNA RPPH1表达水平与miR-145-3p表达水平呈负相关(r=-0.663,P<0.05)。ROC曲线分析结果显示,血清lncRNA RPPH1、miR-145-3p联合预测重度MP感染的曲线下面积(AUC)为0.898,大于血清lncRNA RPPH1、miR-145-3p单独预测的AUC(Z=2.065、2.106,P=0.039、0.035)。根据随访结果,76例患儿纳入预后良好组,48例患儿纳入预后不良组。预后不良组血清lncRNA RPPH1表达水平低于预后良好组,血清miR-145-3p表达水平高于预后良好组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,血清lncRNA RPPH1、miR-145-3p联合预测MP感染患儿预后不良的AUC为0.927,大于血清lncRNA RPPH1、miR-145-3p单独预测的AUC(Z=2.590、2.385,P=0.010、0.017)。多因素Logistic回归分析结果显示,血清lncRNA RPPH1<0.836,miR-145-3p≥1.224是MP感染患儿预后不良的危险因素(P<0.05)。结论MP感染患儿血清lncRNA RPPH1水平显著降低,miR-145-3p水平显著升高,且相比于血清lncRNA RPPH1、miR-145-3p单独预测,二者联合预测重度MP感染及MP患儿预后不良的效果更好。
Objective To explore the predictive value of serum lncRNA RPPH1 and miR-145-3p for the severity and prognosis of Mycoplasma pneumoniae(MP)infection in children.Methods A total of 124 children with MP infection who received treatment in the hospital from June 2020 to May 2023 were selected as the MP infection group,and 124 healthy children who underwent physical examination in the hospital during the same period were selected as the control group.According to the CURB-65 scoring system,the severity of MP-infected children was assessed and divided into severe group and mild group.The patients were followed up for 6 months and divided into good prognosis group and poor prognosis group.The expression levels of serum lncRNA RPPH1 and miR-145-3p were detected by real-time fluorescence quantification and polymerase chain reaction.The correlation between the expression level of serum lncRNA RPPH1 and miR-145-3p in MP infected children was analyzed by Pearson correlation.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of serum lncRNA RPPH1 and miR-145-3p in severe MP infection and the predictive value of poor prognosis in children with MP infection.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in children with MP infection.Results The expression level of serum lncRNA RPPH1 in MP infection group was lower than that in control group,and the expression level of serum miR-145-3p in MP infection group was higher than that in control group,with statistical significance(P<0.05).Fifty-nine children were included in the severe group and 65 children were included in the mild group.The expression level of lncRNA RPPH1 in severe group was lower than that in mild group,and the expression level of miR-145-3p in severe group was higher than that in mild group,with statistical significance(P<0.05).lncRNA RPPH1 and miR-145-3p were predicted to have binding sites.Pearson correlation analysis showed that the expression level of serum lncRNA RPPH1 was negatively correlated with the expression level of miR-145-3p in children with MP infection(r=-0.663,P<0.05).ROC curve analysis results showed that the area under the curve(AUC)of serum lncRNA RPPH1 and miR-145-3p combined to predict severe MP infection was 0.898,which was larger than the AUC predicted by serum lncRNA RPPH1 and miR-145-3p alone(Z=2.065,2.106;P=0.039,0.035).According to the follow-up results,76 children were included in the good prognosis group and 48 children were included in the poor prognosis group.The expression level of serum lncRNA RPPH1 in the poor prognosis group was lower than that in the good prognosis group,and the expression level of serum miR-145-3p in the poor prognosis group was higher than that in the good prognosis group,with statistical significance(P<0.05).ROC curve analysis results showed that the AUC of serum lncRNA RPPH1 and miR-145-3p combined in predicting poor prognosis of MP-infected children was 0.927,which was larger than the AUC of serum lncRNA RPPH1 and miR-145-3p alone(Z=2.590,2.385,2.30;P=0.010,0.017).Multivariate Logistic regression analysis showed that serum lncRNA RPPH1<0.836 and miR-145-3p≥1.224 were risk factors for poor prognosis in children with MP infection(P<0.05).Conclusion The serum lncRNA RPPH1 level in children with MP infection is greatly reduced,while the miR-145-3p level is greatly increased.The combination of the two has a better diagnostic effect on the severity of MP infection and has good prognostic evaluation value.
作者
马亚波
高珊
董艳菊
MA Yabo;GAO Shan;DONG Yanju(The Second Department of Pediatric,Baoding Second Central Hospital,Baoding,Hebei 072750,China;The Second Department of Respiratory,Baoding Second Central Hospital,Baoding,Hebei 072750,China)
出处
《检验医学与临床》
2025年第8期1121-1126,共6页
Laboratory Medicine and Clinic
基金
河北省保定市科技计划项目(2041ZF219)。
