外周血microRNA-24、YKL-40 与儿童病毒性肺炎的相关性

目的 探讨病毒性肺炎患儿外周血清microRNA-24（miR-24）和YKL-40 表达水平的变化， 以及与肺功能和治疗结局的相关性。方法 选取2018 年9 月—2019 年4 月在浙江大学医学院附属儿童医院 住院的117 例病毒性肺炎患儿作为实验组，选取同期30 例该院行健康体检儿童作为对照组。采用实时荧光定 量聚合酶链反应检测外周血清miR-24 mRNA，酶联免疫吸附试验测定血清YKL-40 含量，潮气肺功能检测 患儿达峰时间比（tPTEF/tE）。结果 与对照组相比，实验组血清miR-24 mRNA 相对表达量降低（P <0.05）， 而YKL-40 含量升高（P <0.05）。重症肺炎患儿血清miR-24 mRNA 相对表达量较轻症患儿低，而YKL-40 含量升高（P <0.05）。不同预后组治疗前后血清miR-24 mRNA 和YKL-40 的差值比较，差异有统计学意义 （P <0.05）；迁延难愈组低于痊愈组和好转组（P <0.05），好转组低于痊愈组（P <0.05）。经Pearson 相关性分析， 治疗前患儿血清miR-24 mRNA 与YKL-40 呈负相关（r =-0.297，P =0.000），与tPTEF/tE 呈正相关（r =0.422， P =0.000）；另外血清YKL-40 与tPTEF/tE 呈负相关（r =-0.394，P =0.000）。结论 血清miR-24 mRNA 和 YKL-40 表达水平在一定程度上可反映病毒性肺炎患儿病情严重程度、肺功能状况和治疗效果，可指导临床 治疗。

Correlation between serum microRNA-24, YKL-40 and virus infectious pneumonia in Children

Objective To investigatethe clinical levels of serum microRNA-24 (miR-24) mRNA, chitinase-3- like-1 protein (YKL-40) in children with virus infectious pneumonia and their relationship with pulmonary function and clinical outcomes. Methods A total of 117 children (in 2 to 11 years old) with virus infectious pneumonia in our hospital from September 2018 to April 2019 were enrolled into the study. At the same time, 30 healthy children were selected as healthy control group. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect serum miR-24 mRNA. ELISA assay was used to analyze serum YKL-40 protein. The time necessary to reach the peak expiratory flow in tidal breathing over the total expiratory time (tPTEF/tE) was detected in tidalbreath pulmonary function test. Results Compared with control group, there were lower miR-24 mRNA levels and higher YKL-40 protein in children with virus infectious pneumonia (P < 0.05). And there were furtherly lower miR-24 mRNA levels and higher YKL-40 protein levels in severe pneumonia children than that in mild pneumonia children (P < 0.05). After treatment, serum miR-24 mRNA levels in fully recovered or improved children were increasing than before treatment (P < 0.05), meanwhile YKL-40 protein levels were decreasing (P < 0.05). But the differences of miR-24 mRNA and YKL-40 protein before and after treatment in invalid group were lower than those in cured group and effective group (P < 0.05). Before treatment, miR-24 mRNA was negatively related with YKL-40 (r = -0.297, P = 0.000), and positively related with tPTEF/tE (r = 0.422, P = 0.000). Besides, YKL-40 was negatively related with tPTEF/tE (r = -0.394, P = 0.000). Conclusions To a certain degree, miR-24 and YKL-40 would reflect the severity of disease, pulmonary function and clinical effect in children with virus infectious pneumonia, which can be provide a clinical supervision.