【摘要】 目的研究哮喘儿童循环血清微小RNA Let-7a的表达水平,探讨其在哮喘诊断及疾病严重程度评估中的价值。方法本研究纳入90例哮喘儿童(哮喘组)和90例健康儿童(健康对照组)作为研究对象,采用酶联免疫吸附试验法检测研究对象血清中白细胞介素(IL)-13水平,所有研究对象均接受肺功能检测,通过实时荧光定量PCR测量血浆Let-7a表达水平。采用受试者工作特征曲线(ROC曲线)分析血清Let-7a对儿童哮喘的诊断价值及其区分重度和中轻度哮喘儿童的能力,采用Pearson线性相关分析血清Let-7a与哮喘儿童肺功能参数和血清IL-13的相关性。结果哮喘组儿童血清Let-7a表达水平显著低于健康对照组儿童(P=0.000),哮喘组儿童血清IL-13水平显著高于健康对照组儿童(P=0.000);哮喘组儿童血清Let-7a表达水平随着哮喘严重程度显著下降(P=0.000)。当最佳临界值为2.09,血清Let-7a诊断哮喘儿童的ROC曲线下面积为0.92(95%CI:0.87～0.95,P=0.001),灵敏度和特异度分别为85.0%和90.0%。当最佳临界值为1.60,Let-7a区分重度和中轻度哮喘的ROC曲线下面积为0.80(95%CI:0.68～0.92,P=0.001),灵敏度和特异度分别为75.0%和93.5%。Let-7a表达水平与IL-13水平呈负相关(r=-0.31,P=0.001),Let-7a表达水平与第1秒用力呼气容积和用力肺活量均呈正相关(r=0.270,P=0.004;r=0.412,P=0.002)。结论 Let-7a可用作血清非侵入性标志物,用于诊断哮喘及其严重程度。更多还原

【Abstract】 Objective To study the expression level of circulating microRNA Let-7a in asthmatic children,and to explore its value in the diagnosis of asthma and the evaluation of disease severity.Methods In this study,90 asthmatic children(asthmatic group)and 90 healthy children(healthy control group)were included as the subjects.The serum level of IL-13 was detected by enzyme-linked immunosorbent assay.All subjects were tested for lung function.The plasma level of Let-7a was measured by real-time fluorescence quantitative PCR.The diagnostic value of serum Let-7a in children with asthma and the ability to distinguish between severe and mild asthma were analyzed by ROC curve.The correlation between serum Let-7a and pulmonary function parameters and serum IL-13 was analyzed by Person linear correlation.Results The expression level of Let-7a in asthmatic children was significantly lower than that in healthy children(P=0.000).The serum IL-13 level in asthmatic children was significantly higher than that in healthy controls(P=0.000).The expression level of serum Let-7a in asthmatic children was significantly decreased with the severity of asthma(P=0.000).When the cut-off value was 2.09,the area under ROC curve for diagnosis of asthma was 0.92(95%CI:0.87-0.95,P=0.001).The specificity and specificity were 85.0%and 90.0%,respectively.When the cutoff value was 1.60,the area under the ROC curve of Let-7a was 0.80(95%CI:0.68-0.92,P=0.001),the sensitivity and specificity were 75.0%and 93.5%,respectively.The expression level of Let-7a was significantly negatively correlated with the level of IL-13(r=-0.31,P=0.001),and the expression level of Let-7a was significantly positively correlated with FEV1(r=0.270,P=0.004)and FVC(r=0.412,P=0.002).Conclusion Let-7a can be used as a serum non-invasive marker for the diagnosis of asthma and severity.更多还原