病毒性脑炎患儿血清microRNA-125b与病情严重程度及预后的关系

Relationship between serum microRNA-125b level and disease severity and prognosis in children with viral encephalitis

摘要:

目的 探究病毒性脑炎（VE）患儿血清microRNA-125b（miR-125b）与病情严重程度和预后的关系。方法 选取2018年1月—2020年3月在舟山市妇女儿童医院儿科就诊的118例VE患儿（重度组55例，轻度组63例），另取同期该院40例健康体检儿童作为对照组。收集研究对象的一般资料、临床检测结果等。提取血浆RNA，采用实时荧光定量聚合酶链反应检测miR-125b相对表达量。分析miR-125b相对表达量与VE患儿临床特征及预后的关系。采用受试者工作特征曲线下面积评价miR-125b对VE患儿预后的诊断价值，并对VE患儿预后的危险因素进行逐步多因素Logistic回归分析。结果 对照组miR-125b相对表达量低于轻度组和重度组（P <0.05）；重度组miR-125b相对表达量高于轻度组（P <0.05）。VE患儿血清miR-125b相对表达量与惊厥、偏瘫、多器官损伤和应激性高血糖呈正相关（r_s =0.034、0.017、0.205和0.160，均P <0.05），与年龄、患者发热、意识障碍、低钠血症无相关性（P >0.05）。血清miR-125b预测VE患儿预后的AUC为0.843（95% CI：0.752，0.891）。当临界值为1.725时，诊断的敏感性（87.5%）、特异性（71.2%）和准确性（76.4%）最高。Logistic回归分析结果显示，惊厥、应激性高血糖、miR-125b是VE患儿预后不良的危险因素（P <0.05）。结论 血清miR-125b与VE的严重程度及预后有关，具有一定的诊断价值。

Abstract:

Objective o explore the relationship between the serum level of microRNA-125b (miR-125b) and disease severity and prognosis of children with viral encephalitis (VE).Methods A total of 118 children with VE (including 55 severe cases and 63 mild cases) seeking medical treatments in the Department of Pediatrics of Zhoushan Women and Children's Hospital from January 2018 to March 2020 were selected, and another 40 healthy children in the hospital during the same period were set as the control group. We collected the clinical data and blood samples of all the participants, and the expression of miR-125b was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The relationship between the expression of miR-125b and the clinical features and prognosis of children with VE was analyzed. The area under the receiver operating characteristic (ROC) curve (AUC) was calculated to evaluate the prognostic value of miR-125b. Logistic regression analysis was conducted to determine the prognostic risk factors of VE.Results Compared with mild group and severe group, the expression of miR-125b in control group was decreased (P < 0.05). Besides, the expression of miR-125b in the severe group was higher than that in the mild group (P < 0.05). The expression of serum miR-125b was positively correlated with convulsions, hemiplegia, multiple organ injury, and stress hyperglycemia (r_s = 0.034, 0.017, 0.205 and 0.160, respectively, all P < 0.05), but was not correlated with age, fever, disturbance of consciousness, hyponatremia, and hypokalemia in children with VE (all P > 0.05). The AUC of serum miR-125b level for predicting the prognosis of VE was 0.843 (95% CI: 0.752, 0.891). When the cut-off value was 1.725, the highest sensitivity (87.5%), specificity (71.2%) and accuracy (76.4%) were observed. In addition, convulsions, stress hyperglycemia and miR-125b were factors affecting the prognosis in children with VE.Conclusions The expression of serum miR-125b is related to and of certain value for predicting the disease severity and prognosis of VE.