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中华临床医师杂志(电子版) ›› 2022, Vol. 16 ›› Issue (04) : 326 -331. doi: 10.3877/cma.j.issn.1674-0785.2022.04.007

临床研究

外周血miRNA-150与CD19+CD24hiCD38hiBreg细胞在儿童免疫性血小板减少症中的变化及意义
钱元原1, 张娟1,(), 季卫刚1, 周金君1, 周美云1   
  1. 1. 226000 江苏南通,南通大学附属妇幼保健院儿内科
  • 收稿日期:2021-08-04 出版日期:2022-04-15
  • 通信作者: 张娟
  • 基金资助:
    南通大学临床医学专项课题项目(2019LY037)

Significance of changes of peripheral blood miRNA-150 and CD19+CD24hiCD38hiBreg cells in children with immune thrombocytopenia

Yuanyuan Qian1, Juan Zhang1,(), Weigang Ji1, Jinjun Zhou1, Meiyun Zhou1   

  1. 1. Department of Pediatrics, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong 226000, China
  • Received:2021-08-04 Published:2022-04-15
  • Corresponding author: Juan Zhang
引用本文:

钱元原, 张娟, 季卫刚, 周金君, 周美云. 外周血miRNA-150与CD19+CD24hiCD38hiBreg细胞在儿童免疫性血小板减少症中的变化及意义[J]. 中华临床医师杂志(电子版), 2022, 16(04): 326-331.

Yuanyuan Qian, Juan Zhang, Weigang Ji, Jinjun Zhou, Meiyun Zhou. Significance of changes of peripheral blood miRNA-150 and CD19+CD24hiCD38hiBreg cells in children with immune thrombocytopenia[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(04): 326-331.

目的

探讨外周血miRNA-150与CD19+CD24hiCD38hiBreg细胞在儿童免疫性血小板减少症(ITP)中变化及意义。

方法

选取南通大学附属妇幼保健院在2017年3月至2020年9月接受诊治的ITP患儿93例,其中新诊断ITP患儿(病程<3个月)56例,持续性ITP患儿(病程3~12个月)37例。另选取本院同期健康体检儿童50例作为对照组。采用实时荧光定量PCR反应测定外周血miRNA-150表达,采用流式细胞术测定CD19+CD24hiCD38hiBreg细胞表达。

结果

ITP患儿外周血miRNA-150表达高于对照组,且CD19+CD24hiCD38hiBreg细胞表达率低于对照组(P<0.05)。持续性ITP组外周血miRNA-150表达高于新诊断ITP组,而CD19+CD24hiCD38hiBreg细胞表达率低于新诊断ITP组(P<0.05)。全反应(CR)组外周血miRNA-150表达低于反应(R)组和无效(NR)组,且R组低于NR组(P<0.05)。CR组CD19+CD24hiCD38hiBreg细胞表达率高于R组和NR组,且R组高于NR组(P<0.05)。外周血miRNA-150对ITP诊断敏感度和特异度分别为78.18%和60.53%;CD19+CD24hiCD38hiBreg细胞表达对ITP诊断敏感度和特异度分别为83.63%和71.05%。miRNA-150与PLT呈负相关(r=-0.738),而CD19+CD24hiCD38hiBreg细胞与PLT呈正相关(r=0.796)。

结论

外周血miRNA-150在ITP患儿中高表达,而CD19+CD24hiCD38hiBreg细胞在ITP患儿中低表达,且外周血miRNA-150和CD19+CD24hiCD38hiBreg细胞表达与疗效密切相关。

Objective

To explore the significance of changes of peripheral blood miRNA-150 and CD19+CD24hiCD38hiBreg cells in children with immune thrombocytopenia (ITP).

Methods

A total of 93 children with ITP treated at the Department of Hematology of Affiliated Maternity and Child Health Care Hospital of Nantong University from March 2017 to September 2020 were selected, including 56 cases with newly diagnosed ITP (course of disease<3 months) and 37 cases with persistent ITP (course of disease 3-12 months). Another 50 healthy children were selected as a control group. The expression of miRNA-150 in peripheral blood was detected by real-time PCR, and the expression of CD19+CD24hiCD38hiBreg cells was detected by flow cytometry.

Results

The expression of miRNA-150 in peripheral blood of ITP children was higher than that of control group, while the expression rate of CD19+CD24hiCD38hiBreg cells was lower than of the control group (P<0.05). The expression of miRNA-150 in the persistent ITP group was higher than that in the newly diagnosed ITP group, while the expression rate of CD19+CD24hiCD38hiBreg cells was lower than that in the newly diagnosed ITP group (P<0.05). The expression of miRNA-150 was lower in the complete remission (CR) group than in the remission (R) group and no-remission (NR) group, and in the R group than in the NR group (P<0.05). The expression rate of CD19+CD24hiCD38hiBreg cells was higher in the CR group than in the R group and NR group, and in the R group than in the NR group (P<0.05). The sensitivity and specificity of peripheral blood miRNA-150 for diagnosing ITP were 78.18% and 60.53%, respectively, and those of CD19+CD24hiCD38hiBreg cells for diagnosing ITP were 83.63% and 71.05%, respectively. The expression miRNA-150 was negatively correlated with platelet count (r=-0.738), while CD19+CD24hiCD38hiBreg cells were positively correlated with platelet count (r=0.796).

Conclusion

The expression of miRNA-150 in peripheral blood is high in children with ITP, while the expression of CD19+CD24hiCD38hiBreg cells is low in children with ITP. The expression of miRNA-150 and CD19+CD24hiCD38hiBreg cells in peripheral blood is closely related to the curative effect.

图1 ITP患儿与健康体检儿童外周血miRNA-150比较(
xˉ
±s
注:与对照组比较,*P<0.05;ITP为免疫性血小板减少症
图2 ITP患儿与健康体检儿童外周血CD19+CD24hiCD38hiBreg细胞表达率比较(
xˉ
±s
注:与对照组比较,*P<0.05;ITP为免疫性血小板减少症
图3 不同病情ITP患儿外周血miRNA-150水平比较(
xˉ
±s
注:与对照组比较,*P<0.05;ITP为免疫性血小板减少症
图4 不同病情ITP患儿CD19+CD24hiCD38hiBreg细胞表达率比较(
xˉ
±s
注:与对照组比较,*P<0.05;ITP为免疫性血小板减少症
图5 不同疗效外周血miRNA-150表达比较(
xˉ
±s
注:与对照组比较,*P<0.05;CR为完全反应;R为反应;NR为无效
图6 不同疗效CD19+CD24hiCD38hiBreg细胞率比较(
xˉ±s
注:与对照组比较,*P<0.05;CR为完全反应;R为反应;NR为无效
表1 外周血miRNA-150和CD19+CD24hiCD38hiBreg细胞表达对ITP诊断价值
图7 外周血miRNA-150和CD19+CD24hiCD38hiBreg细胞表达对ITP诊断价值ROC曲线 注:ITP为免疫性血小板减少症
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