miR-1165-3p、miR-145水平在支气管哮喘患者中的表达及其临床意义

摘要 目的：探讨微小RNA（MicroRNA，miR）-1165-3p、miR-145水平在支气管哮喘患者中的表达及其临床意义。方法：收集2021年1月-2022年3月中国人民解放军总医院第六医学中心62例支气管哮喘患者作为研究组，其中轻度急性发作27例，中度急性发作22例，重度急性发作13例。另收集同时期、同年龄段30例健康体检者作为对照组。采用实时荧光定量PCR（RT-PCR）检测各组血清miR-1165-3p、miR-145表达水平。采用Spearman相关分析不同程度支气管哮喘患者与血清miR-1165-3p、miR-145之间的相关性。通过受试者工作特征（ROC）分析血清miR-1165-3p、miR-145表达水平对不同程度支气管哮喘的诊断效能。结果：与对照组相比，研究组中白细胞介素-6（IL-6）、嗜酸性粒细胞、总免疫球蛋白E（IgE）水平显著升高，第1秒用力呼气容积（FEV₁）占预测值百分比（FEV₁%）则显著降低，差异均有统计学意义（P＜0.05）。不同严重程度支气管哮喘患者（轻度、中度、重度）血清miR-1165-3p、miR-145表达水平均高于健康对照组，支气管哮喘越严重，其表达水平越高，且组间、组内比较差异均有统计学意义（P＜0.05）。Spearman相关分析显示，miR-1165-3p、miR-145、IL-6表达水平与哮喘严重程度呈正相关（P＜0.05），FEV₁%与哮喘严重程度呈负相关（P＜0.05），嗜酸性粒细胞、总IgE与哮喘严重程度无相关性（P＞0.05）。对轻度、中度、重度急性支气管哮喘发作的诊断效能显示：血清miR-1165-3p的曲线下面积（AUC）（0.95CI）分别为3.085（0.326～29.221）、0.712（0.611～0.829）、0.755（0.602～0.948）。血清miR-145的AUC（0.95CI）分别为0.833（0.708～0.979）、0.754（0.590～0.964）、0.816（0.671～0.993）。结论：血清miR-1165-3p、miR-145表达水平具有较高的诊断效能，支气管哮喘越严重，诊断的特异性越高，可作为支气管哮喘严重程度的无创诊断指标。

Expression and Clinical Significance of miR-1165-3p and miR-145 in Patients with Bronchial Asthma

ABSTRACT Objective: To investigate the expression and clinical significance of MicroRNA(miR)-1165-3p and miR-145 levels in patients with bronchial asthma. Methods: 62 patients with bronchial asthma in The Sixth Medical Center of the General Hospital of the Chinese People''s Liberation Army from January 2021 to March 2022 were selected as the research group, including 27 cases of mild acute attack, 22 cases of moderate acute attack and 13 cases of severe acute attack. Another 30 healthy subjects of the same period and age were collected as the control group. Quantitative Real-time PCR(RT-PCR) was used to detect the expression levels of serum miR-1165-3p and miR-145 in each group. Spearman correlation analysis was used to analyze the correlation between serum miR-1165-3p and miR-145 in patients with different degrees of bronchial asthma. The diagnostic efficacy of serum miR-1165-3p and miR-145 in different degrees of bronchial asthma was analyzed by receiver operating characteristic (ROC). Results: Compared with the control group, the levels of IL-6, eosinophils and total IgE in the study group were significantly increased, while forced expiratory volume in the first second(FEV₂) of forecast(FEV₂%) was significantly decreased (P<0.05). The expression levels of serum miR-1165-3p and miR-145 in patients with bronchial asthma of different severity (mild, moderate and severe) were higher than those in healthy control group, the more severe bronchial asthma was, the higher the expression level was, and the difference between groups and within groups was statistically significant(P<0.05). Spearman correlation analysis showed that the expression levels of miR-1165-3p, miR-145 and IL-6 were positively correlated with the severity of asthma(P<0.05), FEV₂% was negatively correlated with the severity of asthma(P<0.05), eosinophils and total IgE were not correlated with the severity of asthma(P>0.05). The area under the curve(AUC) (0.95CI) of serum miR-1165-3p in the diagnosis of mild, moderate and severe acute bronchial asthma were 3.085 (0.326-29.221), 0.712 (0.611-0.829) and 0.755 (0.602-0.948), respectively. The AUC (0.95ci) of miR-145 was 0.833(0.708-0.979), 0.754(0.590-0.964), 0.816(0.671-0.993),respectively. Conclusion: Serum miR-1165-3p, miR-145 expression levels have high diagnostic efficiency, the more severe bronchial asthma, the higher the specificity of diagnosis, which can be used as non-invasive diagnostic indicators of bronchial asthma severity.