摘要
目的探讨核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、miR-223在过敏性紫癜(HSP)患儿外周血中的水平变化及临床意义,并分析二者相关性。方法选取2019年7月至2020年5月恩施土家族苗族自治州中心医院收治的HSP患儿60例为HSP组,选取同期来本院体检且与患者一般资料匹配的健康体检儿童60例为对照组。收集研究对象一般资料,比较分析两组对象淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))和免疫球蛋白(IgA、IgG、IgM)水平;采用实时荧光定量PCR(qRT-PCR)法检测外周血miR-223水平,酶联免疫(ELISA)法检测NLRP3水平;Pearson法分析NLRP3与miR-223表达的相关性及NLRP3、miR-223与淋巴细胞亚群和免疫球蛋白水平的相关性;受试者工作特征(ROC)曲线评价血清NLRP3和miR-223水平对HSP发生的诊断价值。结果与对照组比较,HSP组患儿外周血NLRP3表达水平明显上调,miR-223表达水平下调,差异均具有统计学意义(P<0.05),HSP组患儿IgA、IgG、IgM、CD8^(+)水平均高于对照组,CD4^(+)、CD4^(+)/CD8^(+)均低于对照组,差异均有统计学意义(P<0.05)。miR-223与IgA、IgG、IgM、CD8^(+)水平呈负相关(r=-0.451、-0.355、-0.274、-0.581,P<0.05),与CD4^(+)、CD4^(+)/CD8^(+)水平呈正相关(r=0.712、0.461,P<0.05);而NLRP3与CD4^(+)、CD4^(+)/CD8^(+)呈正相关(r=0.553、0.348、0.294、0.456,P<0.05),与IgA、IgG、IgM、CD8^(+)呈负相关(r=-0.484、-0.354,P<0.05);HSP患儿外周血中NLRP3和miR-223呈负相关(r=-0.340,P<0.05);ROC结果显示,血清miR-223、NLRP3水平预测HSP患儿的曲线下面积(AUC)分别为0.974(95%CI:0.928~0.995)、0.956(95%CI:0.902~0.985),对应的敏感度分别为98.33%、83.33%,特异度分别为88.33%、96.67%,二者联合预测HSP患儿的AUC为0.987(95%CI:0.947~0.999),敏感度为98.33%,特异度为90.00%。结论NLRP3在HSP患儿外周血中呈高表达,miR-223低表达,二者呈负相关,且二者联合检测有助于诊断HSP。
Objective To investigate the level changes and clinical significance of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)and miR-223 in the peripheral blood of children with Henoch-Schonlein purpura(HSP),and to analyze their correlation.Methods Sixty children diagnosed with HSP in Enshi Tujia and Miao Autonomous Prefecture Central Hospital from July 2019 to May 2020 were selected as the HSP group,and 60 healthy children who came to our hospital for physical examination during the same period and matched with the general information of the patients were selected as the control group.The general information of the research subjects was collected,and the levels of lymphocyte subgroups(CD3^(+),CD4^(+),CD4^(+)/CD8)and immunoglobulins(IgA,IgG,IgM)in the two groups were compared and analyzed;real-time fluorescent quantitative PCR(qRT-PCR)method was used to detect the level of miR-223 in peripheral blood;enzyme-linked immunoassay(ELISA)method was used to detect the level of NLRP3;Pearson method was used to analyze the correlation between NLRP3 and miR-223 expression and the correlation between NLRP3,miR-223 and lymphocyte subsets and immunoglobulin levels;receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of serum NLRP3 and miR-223 levels for the occurrence of HSP.Results Compared with the control group,the expression level of NLRP3 in the peripheral blood of children in the HSP group was significantly up-regulated,the expression level of miR-223 was down-regulated,and the differences were statistically significant(P<0.05).IgA,IgG,IgM and CD8^(+)of children in HSP group were higher than those in control group,and CD4^(+)and CD4^(+)/CD8^(+)were lower than those in control group.miR-223 was negatively correlated with IgA,IgG,IgM and CD8^(+)(r=-0.451/-0.355/-0.274/-0.581,P<0.05),and positively correlated with CD4^(+)and CD4^(+)/CD8^(+)levels(r=0.712/0.461,P<0.05);while NLRP3 was positively correlated with CD4^(+)and CD4^(+)/CD8^(+)(r=0.553/0.348/0.294/0.456,P<0.05),and negatively correlated with IgA,IgG,IgM and CD8^(+)(r=-0.484/-0.354,P<0.05);there was a negative correlation between NLRP3 and miR-223 in peripheral blood of children with HSP(r=-0.340,P<0.05);ROC results showed that the area under the curve(AUC)of serum miR-223 and NLRP3 levels predicting children with HSP was 0.974(95%CI:0.928~0.995)and 0.956(95%CI:0.902~0.985)respectively,the corresponding sensitivity was 98.33%and 83.33%respectively,and the specificity was 88.33%and 96.67%respectively,the AUC of the combination of the two predicting children with HSP was 0.987(95%CI:0.947~0.999),the sensitivity was 98.33%,and the specificity was 90.00%.Conclusions NLRP3 is obviously highly expressed in the peripheral blood of children with HSP,and miR-223 is obviously lowly expressed.There is a significant negative correlation between the two,and the combined detection of the two is helpful to diagnose the occurrence of HSP and has important clinical value.
作者
黄丽芳
刘景珍
徐江维
饶媚
谢根
HUANG Lifang;LIU Jingzhen;XU Jiangwei;RAO Mei;XIE Gen(Department of Children’s Blood Digestion,Cardiovascular Nephrology,Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,China)
出处
《安徽医学》
2022年第7期768-772,共5页
Anhui Medical Journal
