血清miR-16与新生儿败血症患儿心功能障碍及炎症反应的关系

目的探究血清miR-16与新生儿败血症患儿心功能障碍及炎症反应的相关性。方法回顾性分析119例新生儿败血症患儿(败血症组)的临床资料,另选取100例同期住院的普通感染新生儿(对照组)作为对照,评估2组患儿心功能、血清炎症因子及血清miR-16表达水平。根据左室射血分数(LVEF)将败血症组患儿分为心功能障碍组及无心功能障碍组,采用多因素Logistic回归分析血清miR-16表达水平对新生儿败血症患儿发生心功能障碍的影响,采用受试者工作特征(ROC)曲线分析血清miR-16表达水平对新生儿败血症患儿发生心功能障碍的诊断价值,采用Pearson法分析新生儿败血症患儿血清miR-16表达水平与炎症因子及心肌损伤标志分子的相关性。结果败血症组患儿的血清miR-16表达水平显著高于对照组患儿(P<0.001)。心功能障碍组患儿的血清miR-16表达、白细胞介素-6(IL-6)、C反应蛋白(CRP)、心肌肌钙蛋白Ⅰ(cTnⅠ)、乳酸脱氢酶(LDH)、肌酸激酶心肌同工酶(CK-MB)、心脏型脂肪酸结合蛋白(H-FABP)水平及QT离散度、Tie指数均显著高于无心功能障碍组患儿,而LVEF则显著低于无心功能障碍组患儿(P<0.001)。多因素Logistic回归分析显示,血清miR-16表达水平是新生儿败血症患儿发生心功能障碍的独立危险因素(P<0.05)。经ROC曲线分析,采用血清miR-16表达水平诊断新生儿败血症患儿发生心功能障碍的曲线下面积(AUC)为0.901(95%CI0.846~0.956),特异度和灵敏度分别为80.7%和85.5%。经Pearson相关性分析,新生儿败血症患儿的血清miR-16表达水平与IL-6、CRP、cTnⅠ、LDH、CK-MB、H-FABP水平呈显著正相关性(r=0.439、0.341、0.325、0.842、0.683、0.705,P<0.001)。结论新生儿败血症患儿血清miR-16升高与炎症反应有关,检测血清miR-16表达水平对新生儿败血症患儿发生心功能障碍有一定诊断价值。

Study on the relationship between serum miR-16 and cardiac dysfunction and inflammatory response in neonates with septicemia

Objective To investigate the correlation between serum miR-16 and cardiac dysfunction and inflammatory response in neonates with septicemia.Methods The clinical data of 119 neonates with septicemia(the septicemia group)were analyzed retrospectively,and 100 cases of general infected neonates(the control group)were selected as the control.The cardiac function,serum inflammatory factors and the expression of miR-16 of the two groups were evaluated.According to left ventricular ejection fraction(LVEF),the neonates with septicemia were divided into the cardiac dysfunction group and the non-cardiac dysfunction group.Multivariate Logistic regression was used to analyze the influence of serum miR-16 expression level on the occurrence of cardiac dysfunction in neonates with septicemia.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum miR-16 expression level on the occurrence of cardiac dysfunction in neonates with septicemia.The correlation between serum miR-16 expression level and inflammatory factors and myocardial injury markers in neonates with septicemia was analyzed by Pearson method.Results The serum miR-16 expression level of neonates in the septicemia group was significantly higher than that in the control group(P<0.001).The serum miR-16 expression,interleukin-6(IL-6),C-reactive protein(CRP),cardiac troponinⅠ(cTnⅠ),lactate dehydrogenase(LDH),creatine kinase isoenzyme(CK-MB),heart fatty acid-binding protein(H-FABP)levels,QT dispersion and Tie index of the cardiac dysfunction group were significantly higher than those of the non-cardiac dysfunction group,while the LVEF of the cardiac dysfunction group was significantly lower than that of the non-cardiac dysfunction group(P<0.001).Multivariate Logistic regression analysis showed that the serum miR-16 expression level was an independent risk factor for the occurrence of cardiac dysfunction in neonates with septicemia(P<0.05).Based on ROC curve analysis,the area under the curve(AUC)of serum miR-16 expression level in diagnosing cardiac dysfunction in neonates with septicemia was 0.901(95%CI:0.846 to 0.956),and the specificity and sensitivity were 80.7%and 85.5%,respectively.According to Pearson correlation analysis,the serum miR-16 expression level of neonates with septicemia was positively correlated with the levels of IL-6,CRP,cTnⅠ,LDH,CK-MB and H-FABP(r=0.439,0.341,0.325,0.842,0.683,0.705,P<0.001).Conclusion The increase of serum miR-16 in neonates with septicemia is associated with inflammatory reaction.And detection of serum miR-16 expression has certain diagnostic value in the occurrence of cardiac dysfunction in neonates with septicemia.