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顾挺, 刘晓庆, 曹凤, 张峰波. 变应性鼻炎患儿外周血miRNA-21表达水平及其临床意义[J]. 实用临床医药杂志, 2021, 25(16): 13-17, 21. DOI: 10.7619/jcmp.20212536
引用本文: 顾挺, 刘晓庆, 曹凤, 张峰波. 变应性鼻炎患儿外周血miRNA-21表达水平及其临床意义[J]. 实用临床医药杂志, 2021, 25(16): 13-17, 21. DOI: 10.7619/jcmp.20212536
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GU Ting, LIU Xiaoqing, CAO Feng, ZHANG Fengbo. Expression level of miRNA-21 in peripheral blood of children with allergic rhinitis and its clinical significance[J]. Journal of Clinical Medicine in Practice, 2021, 25(16): 13-17, 21. DOI: 10.7619/jcmp.20212536
Citation: GU Ting, LIU Xiaoqing, CAO Feng, ZHANG Fengbo. Expression level of miRNA-21 in peripheral blood of children with allergic rhinitis and its clinical significance[J]. Journal of Clinical Medicine in Practice, 2021, 25(16): 13-17, 21. DOI: 10.7619/jcmp.20212536
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变应性鼻炎患儿外周血miRNA-21表达水平及其临床意义

Expression level of miRNA-21 in peripheral blood of children with allergic rhinitis and its clinical significance

    摘要
  • 摘要:
      目的   探讨变应性鼻炎(AR)患儿外周血miRNA-21表达水平及其临床意义。
      方法   选取108例AR患儿纳入AR组，选取45例健康儿童纳入对照组。AR组患儿采用丙酸氟替卡松鼻喷剂联合孟鲁司特钠咀嚼片治疗4周，比较AR组患儿治疗前后miRNA-21、嗜酸性粒细胞(EOS)计数、嗜酸性粒细胞阳离子蛋白(ECP)、总IgE(TIgE)水平与对照组的差异。采用Pearson相关分析探讨AR患儿治疗前后miRNA-21、EOS计数、ECP、TIgE与视觉模拟评分法(VAS)评分的相关性; 采用受试者工作特征(ROC)曲线分析miRNA-21、EOS计数、ECP和TIgE对AR患儿治疗后显效的评估效能。
      结果   治疗4周后, AR组显效84例(占77.78%); AR组患儿治疗前miRNA-21、ECP、TIgE及外周血EOS计数水平高于治疗后及对照组, AR组患儿治疗后miRNA-21表达水平高于对照组，差异有统计学意义(P < 0.05)。治疗后, AR组VAS评分低于治疗前，差异有统计学意义(P < 0.05)。AR组患儿治疗前miRNA-21、EOS计数、ECP与VAS评分呈显著正相关(r=0.568、0.433、0.352); AR组患儿治疗后miRNA-21、EOS计数和ECP与VAS评分均无相关性。miRNA-21、ECP、EOS计数、TIgE评估AR患儿治疗后显效的曲线下面积(AUC)分别为0.913、0.859、0.694、0.688, 其中miRNA-21的AUC大于ECP、EOS计数、TIgE, ECP的AUC大于EOS计数、TIgE, 差异有统计学意义(P < 0.05), 而EOS计数、TIgE的AUC相比，差异无统计学意义(P>0.05)。miRNA-21联合ECP评估AR患儿治疗后显效的AUC为0.984(95%CI为0.863~0.995, P < 0.05), 诊断灵敏度为94.75%时，特异度可达90.52%。
      结论   AR患儿血清miRNA-21表达水平显著升高，能一定程度反映AR患儿病情的严重程度，单独应用miRNA-21或联合应用ECP与miRNA-21可较好地预测AR患儿的临床疗效。

     

    Abstract:
      Objective   To investigate expression level of serum miRNA-21 in children with allergic rhinitis(AR).
      Methods   A total of 108 AR children and 45 healthy children were respectively included in AR group and control group. All children with AR were treated with Fluticasone Propionate Nasal Spray combined with Montelukast Sodium Chewable Tablets for 4 weeks. The levels of miRNA-21, eosinophil (EOS) count, eosinophil cationic protein (ECP) and total IgE (TIgE) levels were compared between two groups before and after treatment. The correlations between miRNA-21, EOS count, ECP, TIgE and Visual Analogue Scale (VAS) scores before and after treatment in children with AR were analyzed by Pearson correlation analysis. The clinical efficacy of miRNA-21, EOS count, ECP and TIgE in evaluating the response condition after treatment in children with AR was explored by Receiver Operating Characteristic (ROC) curve.
      Results   A total of 84 children (77.78%) with ARacquired significant efficiency after 4 weeks of treatment. The levels of miRNA-21, ECP, TIgE and EOS count in the AR group were significantly higher than after treatment and control group, and the level of miRNA-21 after treatment in the AR group was significantly higher than those of the control group (P < 0.05). The VAS scores of AR children decreased significantly after treatment (P < 0.05). Before treatment, miRNA-21, EOS count and ECP in the children of the AR group showed significantly positive correlations with VAS scores (r=0.568, 0.433, 0.352). However, there were no correlations between miRNA-21, EOS count, ECP and VAS scores in the AR group after treatment. The Area Under the Curves (AUC) of miRNA-21, ECP, EOS counts, TIgE were 0.913, 0.859, 0.694 and 0.688, respectively. The AUC of miRNA-21 was significantly higher than ECP, EOS counts and TIgE, the AUC of ECP was significantly higher than EOS counts and TIgE, the differences were significant(P < 0.05). However, the comparison of AUCs of EOS counts and TIgE showed no significant difference (P>0.05). The AUC of miRNA-21 combined with ECP in evaluating the significant efficiency after 4 weeks of treatment in children with AR was 0.984 (95%CI, 0.863 to 0.995, P < 0.05), and the specificity and sensitivity was 90.52% and 94.75%, respectively.
      Conclusion   The expression of miRNA-21 in children with AR is significantly higher, which can reflect the severity of the disease. Combined detection of miRNA-21 and ECP or miRNA-21 alone both can predict the clinical efficacy of children with AR.

     

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