广西医学

目的探讨血清miR⁃155与miR⁃147a表达水平与肺炎支原体（MP）肺炎患儿预后的关系。方法选取82例MP肺炎患儿作为肺炎组，同期参加体检的82例健康儿童作为对照组。比较两组研究对象的血清miR⁃155、miR⁃147a表达水平。根据MP肺炎患儿治疗28 d后的预后情况分为预后良好组和预后不良组，采用多因素Logistic回归模型分析MP肺炎患儿不良预后的影响因素。采用受试者工作特征（ROC）曲线评价血清miR⁃155、miR⁃147a表达水平对MP肺炎患儿不良预后的预测价值。结果肺炎组血清miR⁃155表达水平高于对照组，血清miR⁃147a表达水平低于对照组（P<0.05）。82例MP肺炎患儿中有14例（17.07%）患儿预后不良。预后不良组的中性粒细胞计数与淋巴细胞计数比值（NLR）、乳酸脱氢酶（LDH）水平、血清miR⁃155表达水平、重症占比高于预后良好组，血清miR⁃147a表达水平低于预后良好组（P<0.05）。NLR、LDH水平及血清miR⁃155表达水平升高、重症是MP肺炎患儿预后不良的危险因素，血清miR⁃147a表达水平升高是MP肺炎患儿预后不良的保护因素（P<0.05）。血清miR⁃155、miR⁃147a表达水平单独及联合预测MP肺炎患儿预后不良的灵敏度分别为0.720、0.793、0.821，特异度分别为0.784、0.716、0.724，曲线下面积分别为0.769、0.858、0.884。结论血清miR⁃155表达水平升高是MP肺炎患儿预后不良的危险因素，血清miR⁃147a表达水平升高是其保护因素，两者对MP肺炎患儿预后不良具有良好的预测效能。

Objective To investigate the relation of serum miR⁃155 and miR⁃147a expressions with the prognosis of children with Mycoplasma pneumoniae (MP) pneumonia. Methods A total of 82 children with MP pneumonia were selected as pneumonia group, and 82 healthy children who underwent physical examination during the same period were selected as control group. The expressions of serum miR⁃155 and miR⁃147a were compared between research subjects of the two groups. Based on the prognosis of children with MP pneumonia after 28 days of treatment, they were divided into favorable prognosis group or poor prognosis group. Multivariate Logistic regression model was used to analyze the influencing factors for poor prognosis in children with MP pneumonia. The receiver operating characteristic (ROC) curve was employed to evaluate the predictive value of serum miR⁃155 and miR⁃147a expressions for poor prognosis in children with MP pneumonia. Results The pneumonia group exhibited a higher expression of serum miR⁃155 and a lower expression of serum miR⁃147a as compared with the control group (P<0.05). Among the 82 children with MP pneumonia, 14 (17.07%) had a poor prognosis. The neutrophil⁃to⁃lymphocyte ratio (NLR), lactate dehydrogenase (LDH) level, serum miR⁃155 expression and proportion of severe cases in the poor prognosis group were higher than those in the favorable prognosis group, and the serum miR⁃147a expression was lower than that in the favorable prognosis group (P<0.05). Elevated NLR, LDH level, serum miR⁃155 expression, and severe disease were risk factors for poor prognosis in children with MP pneumonia, and elevated serum miR⁃147a expression was a protective factor for poor prognosis in children with MP pneumonia (P<0.05). The sensitivities of serum miR⁃155 and miR⁃147a expressions alone and in combination to predict the poor prognosis of children with MP pneumonia were 0.720, 0.793 and 0.821, respectively, the specificities were 0.784, 0.716 and 0.724, respectively, and the areas under the curve were 0.769, 0.858 and 0.884, respectively. Conclusion The elevated expression of serum miR⁃155 is a risk factor for the poor prognosis of children with MP pneumonia, whereas the elevated expression of serum miR⁃147a is a protective factor. Both of them have favorable predictive efficiency for the poor prognosis of children with MP pneumonia.