摘要
目的 通过检测变应性鼻炎(AR)患儿血清微小RNA-142(miR-142)、微小RNA-181a(miR-181a)水平分析对疗效的预测价值,为临床治疗提供帮助。方法 回顾性选取南阳市中心医院耳鼻喉科于2021年1月至2022年12月收治的179例AR患儿为研究对象。根据患儿舌下特异性免疫治疗(SLIT)3个月后的临床疗效分为有效组(n=127)和无效组(n=52)。Pearson法分析AR患儿血清miR-142、miR-181a水平与辅助性T细胞17(Th17)、调节性T细胞(Treg)、Th17/Treg的相关性;多因素logistic回归分析影响AR患儿疗效的因素;受试者工作特征(ROC)曲线分析血清miR-142和miR-181a水平对AR患儿临床疗效的预测价值。结果 与有效组比较,无效组Th17、Th17/Treg和miR-142水平显著升高(t=4.700、12.810、9.956,P<0.05),Treg和miR-181a水平显著降低(t=7.529、10.644,P<0.05);AR患儿血清miR-142水平与Th17和Th17/Treg呈正相关(r=0.468、0.523,P<0.05),与Treg呈负相关(r=-0.547,P<0.05);AR患儿血清miR-181a水平与Th17和Th17/Treg呈负相关(r=-0.516、-0.498,P<0.05),与Treg呈正相关(r=0.562,P<0.05)。多因素logistic回归显示,miR-142(OR=1.338)、Th17(OR=1.314)、Th17/Treg(OR=1.358)为影响AR患儿疗效的独立危险因素(P<0.05),miR-181a(OR=0.706)和Treg(OR=0.741)为其保护因素(P<0.05);ROC结果显示,血清miR-142和miR-181a联合预测AR患儿临床疗效的曲线下面积(AUC)(0.894)显著大于miR-142单独预测的AUC(Z=3.144,P=0.002)和miR-181a单独预测的AUC(Z=2.341,P=0.019)。结论 AR患儿血清miR-142和miR-181a水平可能与其免疫平衡有关,二者联合对AR患儿临床疗效具有较高的预测价值。
Objective To explore the levels of serum microRNA-142(miR-142)and microRNA-181a(miR-181a)in children with allergic rhinitis(AR)and their predictive value for clinical efficacy.Provide help for clinical treatment.Methods A retrospective analysis was conducted on 179 children with AR admitted to our hospital between January 2021 and December 2022.Based on the clinical efficacy of sublingual specific immunotherapy(SLIT)after 3 months,patients were divided into the effective group(n=127)and the ineffective group(n=52).The correlation between serum miR-142,miR-181a levels and helper T cells 17(Th17),regulatory T cells(Treg),and Th17/Treg ratio was analyzed using Pearson correlation.Multivariate logistic regression was used to analyze factors influencing clinical efficacy in AR children.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of serum miR-142 and miR-181a levels for clinical efficacy in AR children.Results Compared with the effective group,the ineffective group showed significantly higher levels of Th17,Th17/Treg ratio,and miR-142(t=4.700,12.810,9.956;P<0.05)and significantly lower levels of Treg and miR-181a(t=7.529,10.644;P<0.05).Serum miR-142 levels in AR children were positively correlated with Th17 and Th17/Treg ratio(r=0.468,0.523;P<0.05)and negatively correlated with Treg(r=-0.547;P<0.05).Serum miR-181a levels were negatively correlated with Th17 and Th17/Treg ratio(r=-0.516,-0.498;P<0.05)and positively correlated with Treg(r=0.562;P<0.05).Multivariate logistic regression revealed that miR-142(OR=1.338),Th17(OR=1.314),and Th17/Treg ratio(OR=1.358)were independent risk factors for clinical efficacy in AR children(P<0.05),while miR-181a(OR=0.706)and Treg(OR=0.741)were protective factors(P<0.05).The ROC analysis showed that the area under the curve(AUC)for the combined prediction of clinical efficacy using serum miR-142 and miR-181a levels was 0.894,which was significantly greater than the AUC for miR-142 alone(Z=3.144,P=0.002)or miR-181a alone(Z=2.341,P=0.019).Conclusion Serum miR-142 and miR-181a levels in AR children may be related to immune balance,and their combination has high predictive value for clinical efficacy.
作者
曲莉
尹昕
张蕊
杨妍
裴明阳
QU Li;YIN Xin;ZHANG Rui;YANG Yan;PEI Ming-yang(Department of Otorhinolaryngology,Nanyang Central Hospital,Nanyang 473000,Henan,China)
出处
《广东医学》
2025年第4期592-597,共6页
Guangdong Medical Journal
基金
河南省医学科技攻关联合共建项目(LHGJ202204019)。
