耐药肺结核患者血清miR-129-3p、miR-144-3p检测的临床价值

doi:10.3969/j.issn.1673-8640.2024.11.015

摘要/Abstract

摘要：

目的探讨血清miR-129-3p和miR-144-3p检测在耐药肺结核中的临床价值。方法收集2021年1月—2022年6月川北医学院附属三台医院行新辅助放化疗的140例耐药肺结核患者（耐药肺结核组），根据治疗6个月的疗效，分为有效组（92例）和无效组（48例）；另选取同期与耐药肺结核患者一般资料相匹配的140名体检健康者作为对照组。比较各组血清miR-129-3p、miR-144-3p表达的差异。采用多因素Logistic回归分析评估耐药肺结核患者疗效的影响因素；采用受试者工作特征（ROC）曲线分析治疗2个月后血清miR-129-3p、miR-144-3p水平和白蛋白、白细胞计数预测耐药肺结核患者疗效的效能。结果与对照组比较，耐药肺结核组血清miR-129-3p、miR-144-3p水平显著降低（P<0.05）。治疗2个月，无效组血清miR-129-3p、miR-144-3p水平均显著低于有效组（P<0.05）。血清miR-129-3p、miR-144-3p、白蛋白和白细胞计数是耐药肺结核患者疗效的影响因素（P<0.05）。治疗2个月后血清miR-129-3p、miR-144-3p、白蛋白、白细胞计数联合预测耐药肺结核患者疗效的曲线下面积为0.956，敏感性为87.50%，特异性为92.39%，优于4项指标单独检测（P<0.05）。结论耐药肺结核患者血清miR-129-3p、miR-144-3p水平显著降低。miR-129-3p、miR-144-3p联合白蛋白、白细胞计数对预测耐药肺结核患者疗效有较高的参考价值。

关键词: miR -129-3p, miR -144-3p, 耐药肺结核, 疗效, 检测

Abstract:

Objective To investigate the roles of serum miR-129-3p and miR-144-3p in drug-resistant pulmonary tuberculosis patients. Methods A total of 140 drug-resistant pulmonary tuberculosis patients who underwent neoadjuvant radiotherapy and chemotherapy in Santai Hospital of North Sichuan Medical University from January 2021 to June 2022 were enrolled. According to the therapeutic effect after 6 months of treatment，they were classified into effective group （92 cases） and ineffective group （48 cases）. Totally，140 healthy subjects who matched the general information of drug-resistant pulmonary tuberculosis patients during the same period were enrolled as control group. The expression levels of serum miR-129-3p and miR-144-3p were compared. Multivariate Logistic regression analysis was used to analyze the influencing factors of therapeutic effect in drug-resistant pulmonary tuberculosis patients. Receiver operating characteristic （ROC） curve analysis was used to analyze the predictive values of serum miR-129-3p，miR-144-3p，albumin and white blood cell count on the therapeutic effect of drug-resistant pulmonary tuberculosis after 2 months of treatment. Results Compared with control group，the levels of serum miR-129-3p and miR-144-3p in drug-resistant pulmonary tuberculosis group were decreased （P<0.05）. After 2 months of treatment，the levels of serum miR-129-3p and miR-144-3p in ineffective group were lower than those in effective group （P<0.05）. Serum miR-129-3p，miR-144-3p，albumin and white blood cell count were influencing factors for the therapeutic effect of drug-resistant pulmonary tuberculosis patients （P<0.05）. After 2 months of treatment，the area under curve of the combination of serum miR-129-3p，miR-144-3p，albumin and white blood cell count in predicting the therapeutic effect of drug-resistant pulmonary tuberculosis patients was 0.956，with the sensitivity of 87.50% and the specificity of 92.39%，which was better than their single determinations （P<0.05）. Conclusions The expression levels of miR-129-3p and miR-144-3p in serum of drug-resistant pulmonary tuberculosis patients are decreased，and the combination with miR-129-3p，miR-144-3p，albumin and white blood cell count play a role in predicting the therapeutic effect of drug-resistant pulmonary tuberculosis patients.

Key words: MiR-129-3p, MiR-144-3p, Drug-resistant pulmonary tuberculosis, Therapeutic effect, Determination

中图分类号:

R446.7

刘健, 徐辉, 杨勇琼, 邓正波. 耐药肺结核患者血清miR-129-3p、miR-144-3p检测的临床价值[J]. 检验医学, 2024, 39(11): 1113-1117.

LIU Jian, XU Hui, YANG Yongqiong, DENG Zhengbo. Roles of serum miR-129-3p and miR-144-3p in drug-resistant pulmonary tuberculosis patients[J]. Laboratory Medicine, 2024, 39(11): 1113-1117.

图/表 7

参考文献 24

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基因	上游引物5'~3'	下游引物5'~3'
miR-129-3p	ACACTCCAGCTGGGAAGCCCTTACCCCAA	TGGTGTCGTGGAGTCG
miR-144-3p	ACACTCCAGCTGGGTACAGTATAGATGATGACT	CTCAACTGGTGTCGTGGA
U6	GACCTCTATGCCAACACAGT	AGTACTTGCGCTCAGGAGGA

基因	上游引物5'~3'	下游引物5'~3'
miR-129-3p	ACACTCCAGCTGGGAAGCCCTTACCCCAA	TGGTGTCGTGGAGTCG
miR-144-3p	ACACTCCAGCTGGGTACAGTATAGATGATGACT	CTCAACTGGTGTCGTGGA
U6	GACCTCTATGCCAACACAGT	AGTACTTGCGCTCAGGAGGA

组别	例数	miR-129-3p	miR-144-3p
对照组	140	1.02±0.28	1.02±0.31
耐药肺结核组	140	0.64±0.21	0.56±0.18
t值		18.846	16.174
P值		<0.001	<0.001

组别	例数	miR-129-3p	miR-144-3p
对照组	140	1.02±0.28	1.02±0.31
耐药肺结核组	140	0.64±0.21	0.56±0.18
t值		18.846	16.174
P值		<0.001	<0.001

组别	例数	年龄/岁	性别				慢性阻塞性肺疾病			糖尿病
组别	例数	年龄/岁	男/[例（%）]		女/[例（%）]		有/[例（%）]		无/[例（%）]	有/[例（%）]		无/[例（%）]
有效组	92	46.53±5.24	54（58.70）		38（41.30）		23（25.00）		69（75.00）	37（40.22）		55（59.78）
无效组	48	47.12±5.68	27（56.25）		21（43.75）		9（18.75）		39（81.25）	15（31.25）		33（68.75）
统计值		0.614	0.077				0.699			1.086
P值		0.540	0.781				0.403			0.297
组别	体重指数/（kg·m-2）			病程/年		总胆红素/（mg·L-1）		白蛋白/（g·L-1）			白细胞计数/（×109·L-1）
有效组	22.51±2.68			16.47±2.34		11.8±3.3		36.52±4.08			6.55±1.54
无效组	22.73±2.81			16.68±2.57		12.6±3.5		32.24±3.69			8.73±2.46
统计值	0.453			0.487		1.319		6.083			6.431
P值	0.651			0.627		0.189		<0.001			<0.001