难治性支原体肺炎患儿血清LncRNA NNT-AS1、IL-17A水平变化及临床意义

闫静; 侯艳苗; 王振华

doi:10.16766/j.cnki.issn.1674-4152.003423

难治性支原体肺炎患儿血清LncRNA NNT-AS1、IL-17A水平变化及临床意义

doi: 10.16766/j.cnki.issn.1674-4152.003423

张家口市妇幼保健院儿科，河北张家口 075000

基金项目:

河北省中医药管理局科研计划项目 2022533

详细信息

通讯作者:
王振华，E-mail：zhongtian2122@163.com

中图分类号: R563.1 R518.9
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出版历程
- 收稿日期: 2023-07-31
- 网络出版日期: 2024-05-27

Changes and clinical significance of serum LncRNA NNT-AS1, IL-17A levels in children with refractory mycoplasma pneumonia

Department of Pediatrics, Zhangjiakou Maternal and Child Health Hospital, Zhangjiakou, Hebei 075000, China

摘要

摘要: 目的探讨血清LncRNA NNT-AS1、白细胞介素(IL)17A在难治性肺炎支原体肺炎(RMPP)患儿中的表达及临床应用价值。方法选取2021年2月—2022年3月张家口市妇幼保健院诊治的148例MPP患儿(MPP组)，根据是否发生RMPP分为RMPP组(48例)和非RMPP组(100例)，以同期60例择期行鞘膜积液手术的患儿为对照组。比较各组血清LncRNA NNT-AS1、IL-17A的差异。采用Pearson相关分析研究血清LncRNA NNT-AS1、IL-17A与炎性指标的相关性。采用多因素logistic回归分析研究影响RMPP发病的因素。采用受试者工作特征曲线分析LncRNA NNT-AS1、IL-17A对RMPP发病的预测价值。结果 MPP组血清LncRNA NNT-AS1、IL-17A均高于对照组(P < 0.05)。MPP组血清LncRNA NNT-AS1、IL-17A与CRP、PCT、IL-6、TNF-α均呈正相关关系(r=0.623~0.721，P＜0.001)。血清LncRNA NNT-AS1、IL-17A升高是影响RMPP发病的独立危险因素。两者联合对MPP患儿发生RMPP的曲线下面积为0.906，优于单独检测。结论 RMPP患儿血清LncRNA NNT-AS1、IL-17A水平升高，是影响RMPP发病的独立危险因素，两者联合检测有助于评估RMPP的发生。
- 难治性肺炎支原体肺炎 /
- 长链非编码RNA NNT-AS1 /
- 白细胞介素17A /
- 预测价值
Abstract: Objective To investigate the expression and clinical value of serum LncRNA NT-AS1 and interleukin (IL) 17A in children with refractory mycoplasma pneumoniae pneumonia (RMPP). Methods A total of 148 children with MPP (MPP group) diagnosed and treated at Zhangjiakou Maternal and Child Health Hospital from February 2021 to March 2022 were selected and divided into RMPP group (48 cases) and non-RMPP group (100 cases) according to whether RMPP occurred. Sixty children who underwent surgery for hydrocele in the same period were selected as the control group. The differences of serum LncRNA NNT-AS1 and IL-17A between all groups were compared. The correlation between serum LncRNA NNT-AS1, IL-17A and inflammatory markers was analyzed by Pearson correlation analysis. Multivariate logistic regression analysis of factors affecting the incidence of RMPP. The predictive value of LncRNA NNT-AS1 and IL-17A in the incidence of RMPP was analyzed by subject operating characteristic curve. Results Serum LncRNA NNT-AS1 and IL-17A in the MPP group were higher than those in the control group (P < 0.05). Serum LncRNA NNT-AS1 and IL-17A in the MPP group were positively correlated with CRP, PCT, IL-6 and TNF-α (r=0.623-0.721, P < 0.001). Elevated levels of serum LncRNA NNT-AS1 and IL-17A were independent risk factors for RMPP. The area under the curve of RMPP in MPP children was 0.906, which was better than that of single detection. Conclusion The elevated levels of serum LncRNA NNT-AS1 and IL-17A in children with RMPP are independent risk factors for the development of RMPP, and the combined detection of LncRNA NNT-AS1 and IL-17A is helpful in assessing the occurrence of RMPP.
- Refractory mycoplasma pneumoniae pneumonia /
- Long chain non coding RNA NNT-AS1 /
- Interleukin 17A /
- Predictive value

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图 1 血清LncRNA NNT-AS1、IL-17A及联合对RMPP预测价值的ROC曲线

Figure 1. ROC curves for individual and combined serum cTnI, NT-proBNP, and CA-125 detection in predicting RMPP

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表 1 MPP组与对照组血清LncRNA NNT-AS1、IL-17A及炎症因子水平比较(x±s)

Table 1. Comparison of serum levels of LncRNA NT-AS1, IL-17A, and inflammatory factors between the MPP group and the control group (x±s)

组别	例数	LncRNA NNT-AS1	IL-17A(ng/L)	CRP(mg/L)	PCT(μg/L)	IL-6(μg/L)	TNF-α(μg/L)
MPP组	148	1.60±0.56	9.95±3.32	27.64±5.60	1.06±0.46	49.75±6.54	6.47±2.83
对照组	60	0.68±0.17	2.25±0.71	3.21±0.74	0.32±0.07	10.31±2.33	3.06±0.73
t值		12.479	17.777	33.625	12.386	45.501	9.193
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

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表 2 RMPP组与非RMPP组一般资料及实验室指标比较

Table 2. Comparison of general data and laboratory indicators between the RMPP group and the non-RMPP group

因素	RMPP组(n=48)	非RMPP组(n=100)	统计量	P值
性别(男/女，例)	27/21	51/49	0.359^a	0.549
年龄(x±s，岁)	6.03±2.14	6.16±2.59	0.302^b	0.763
发热时间(x±s，d)	9.14±3.21	5.46±1.84	8.846^b	< 0.001
体温(x±s，℃)	39.32±2.15	39.14±2.20	0.469^b	0.640
病程(x±s，d)	12.25±2.55	10.17±2.47	4.746^b	< 0.001
白细胞数目(x±s，×10⁹/L)	13.14±2.11	12.97±2.23	0.442^b	0.659
中性粒细胞(x±s，%)	81.08±7.21	80.22±6.55	0.723^b	0.471
累及范围≥2/3肺叶[例(%)]	30(62.50)	35(35.00)	9.958^a	0.002
胸腔积液[例(%)]	7(14.58)	11(11.00)	0.390^a	0.532
LncRNA NNT-AS1(x±s)	2.08±0.59	1.37±0.36	9.043^b	< 0.001
IL-17A(x±s，ng/L)	11.95±4.07	8.98±2.36	5.577^b	< 0.001
CRP(x±s，mg/L)	35.32±7.71	19.15±6.24	13.646^b	< 0.001
PCT(x±s，μg/L)	1.57±0.50	0.81±0.15	13.988^b	< 0.001
IL-6(x±s，μg/L)	66.78±7.84	41.58±5.34	22.944^b	< 0.001
TNF-α(x±s，μg/L)	8.29±1.67	5.97±1.14	9.906^b	< 0.001
注：^a为χ²值，^b为t值。

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表 3 影响RMPP的多因素logistic回归分析

Table 3. Multivariate logistic regression analysis of multiple factors influencing RMPP

模型	变量	B	SE	Waldχ²	P值	OR值	95% CI
1	LncRNA NNT-AS1	0.460	0.133	11.962	< 0.001	1.584	1.221~2.056
	IL-17A	0.582	0.162	12.907	< 0.001	1.790	1.303~2.458
2	LncRNA NNT-AS1	0.197	0.093	4.487	0.034	1.218	1.015~1.461
	IL-17A	0.310	0.121	6.564	0.010	1.363	1.076~1.728
注：模型1为未校正；模型2校正发热时间、病程、肺受累范围≥2/3肺叶、CRP、PCT、IL-6、TNF-α。

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表 4 血清LncRNA NNT-AS1，IL-17A及联合对RMPP的预测价值

Table 4. Predictive value of serum LncRNA NNT-AS1, IL-17A, and their combination for RMPP

指标	约登指数	截断值	灵敏度(%)	特异度(%)	AUC	AUC的95% CI
LncRNA NNT-AS1	0.668	1.92	70.8	96.0	0.848	0.780~0.901
IL-17A	0.395	10.60 ng/L	62.5	77.0	0.727	0.648~0.797
两者联合	0.682		79.2	89.0	0.906	0.847~0.948

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