MicroRNA-590和microRNA-196b在儿童IgA肾病诊断中的价值

Values of microRNA-590 and microRNA-196b in diagnosis of IgA nephropathy children

摘要:

目的 探讨IgA肾病患儿血清microRNA-590（miR-590）、microRNA-196b（miR-196b）水平的变化及其临床价值。方法 选取2017年9月—2019年5月于青海省妇女儿童医院肾活检患儿118例，83例确诊为IgA肾病患儿，35例为其他肾小球疾病患儿，另选取同期该院体检健康儿童42例为对照组。通过qRT-PCR法检测受试者血清miR-590、miR-196b表达水平。参照Lee氏分级分别对IgA肾病患儿进行病理学分级。绘制受试者工作特征（ROC）曲线评价血清miR-590、miR-196b及二者联合检测对IgA肾病的诊断价值。结果 3组肌酐、24 h蛋白尿、血清IgA水平比较，差异有统计学意义（P <0.05），IgA肾病组肌酐、24 h蛋白尿、血清IgA水平较对照组、非IgA肾病组升高（P <0.05），白蛋白水平较对照组、非IgA肾病组下降（P <0.05）。3组miR-590 mRNA、miR-196b mRNA相对表达量比较，差异有统计学意义（P <0.05），IgA肾病组miR-590 mRNA相对表达量较对照组、非IgA肾病组下降（P <0.05），miR-196b mRNA相对表达量较对照组、非IgA肾病组升高（P <0.05）。不同程度IgA肾病患儿miR-590 mRNA、miR-196b mRNA相对表达量比较，差异有统计学意义（P <0.05），IgA肾病组患儿miR-590相对表达量随病情加重依次下降（P <0.05），miR-196b相对表达量随病情加重依次升高（P <0.05）。ROC曲线显示，miR-590、miR-196b及两者联合检测诊断IgA肾病的曲线下面积分别为0.873、0.785和0.904，敏感性为84.1%、90.7%和88.6%，特异性为82.6%、64.8%和87.0%。结论 IgA肾病患儿血清miR-590低表达、血清miR-196b高表达，两者联合对IgA肾病具有较高的诊断价值。

Abstract:

Objective To investigate the changes and clinical values of serum microRNA-590 (miR-590) and microRNA-196b (miR-196b) levels in children with IgA nephropathy.Methods From September 2017 to May 2019, the children underwent renal biopsy in our hospital were collected, among them, 83 cases were diagnosed as IgA nephropathy, 35 children with other glomerular diseases, and another 36 healthy children without kidney disease were selected as the control group. The expression levels of miR-590 and miR-196b were detected by qRT-PCR. According to Lee's classification, the pathological classification of IgA nephropathy was carried out. The diagnostic values of serum miR-590, miR-196b and their combined detection in IgA nephropathy were evaluated by drawing the receiver operation characteristic curve (ROC).Results Compared with the control group and non-IgA nephropathy group, the levels of creatinine, 24-hour album inuria, and serum IgA in IgA nephropathy group increased (P < 0.05), while the level of albumin decreased (P < 0.05). There was no significant difference in the levels of miR-590 and miR-196b between the non-IgA nephropathy group and the control group (P > 0.05), the expression level of miR-590 decreased in IgA nephropathy group (P < 0.05), and decreased with the aggravation of the disease, the difference between the any two groups was statistically significant (P < 0.05); the expression level of miR-196b increased (P < 0.05), and increased with the aggravation of the disease, and the difference between the any two groups was statistically significant (P < 0.05); ROC curve showed that the area under the curve of miR-590, miR-196b, and combinationin diagnosing IgA nephropathy was 0.873 (sensitivity was 84.1%, and specificity was 82.6%), 0.785 (sensitivity was 90.7%, and specificity was 64.8%), 0.904 (sensitivity was 88.6%, and specificity was 87.0%), compared with the level of miR-196b in the diagnosis of IgA nephropathy, the diagnosis effect of combined detection of miR-590 and miR-196b was higher (P < 0.05).Conclusions The expression of miR-590 in serum of children with IgA nephropathy is low, and the expression of miR-196b in serum is high, the combination of the two has high diagnostic value for IgA nephropathy.