To investigate the levels and clinical significance of serum microRNA (miR)-146a, miR-145, T-helpertype17 (Th17)/regulatory T cell (Treg) in children with respiratory syncytial virus (RSV) infectious pneumonia. The clinical data of 200 children with RSV infectious pneumonia admitted to Nantong Maternal and Child Health Hospital from June 2020 to June 2023 were retrospectively collected as the study group. At the same time, 200 children with mycoplasma pneumonia were selected as the common pneumonia group and 200 healthy children were selected as the healthy group. The levels of serum inflammatory factors [interleukin-6 (IL-6), interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α)] were detected by enzyme-linked immunosorbent assay. The expression levels of serum miR-146a and miR-145 were detected by RT-qPCR. The levels of Th17/Treg were detected by flow cytometry. The levels of miR-146a, miR-145, Th17/Treg and serum inflammatory factors were compared among the three groups. Pearson method was used to analyze the correlation between miR-146a, miR-145, Th17/Treg and serum inflammatory factors in children with RSV infectious pneumonia. The receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of miR-146a, miR-145, Th17/Treg in children with respiratory syncytial virus infection pneumonia. The results showed that in the study group, miR-146a (2.01±0.58), miR-145 (1.81±0.46), Th17/Treg (1.09±0.31), IL-6 (7.82±2.11) ng/L and TNF-α (9.82±2.96) ng/L were higher than those in the common pneumonia group miR-146a (1.49±0.42), miR-145 (1.43±0.31), Th17/Treg (0.77±0.24), IL-6 (5.89±1.32) ng/L, TNF-α (7.34±2.32) ng/L and healthy group miR-146a (1.25±0.19), miR-145 (1.19±0.16), Th17/Treg (0.38±0.09), IL-6 (4.52±1.04) ng/L, TNF-α (5.39±1.07)ng/L. The levels of the above indexes in the common pneumonia group were higher than those in the healthy group, and the differences were statistically significant (F=183.543, 175.938, 617.182, 226.657, 193.459, P<0.05). In the study group, IFN-γ (14.18±3.25) pg/ml was lower than that in the control group (19.52±5.13) pg/ml, but higher than that in the healthy group (9.77±2.40) pg/ml, and the difference was statistically significant (F=335.432, P<0.05). Pearson correlation analysis showed that miR-146a, miR-145 and Th17/Treg were positively correlated with IL-6 and TNF-α (P<0.05), but negatively correlated with IFN-γ (P<0.05). ROC curve results showed that the area under the curve (AUC) of miR-146a, miR-145 and Th17/Treg in the diagnosis of RSV infectious pneumonia was 0.767, 0.762 and 0.790, respectively, while the combined detection of the three was 0.904. In conclusion, the levels of miR-146a, miR-145 and Th17/Treg are highly expressed in children with RSV infectious pneumonia, and are closely related to the inflammatory response of children. The combined detection of the three may have certain application value in the auxiliary diagnosis of RSV infectious pneumonia.
探讨呼吸道合胞病毒(RSV)感染性肺炎患儿血清微小核糖核酸(miR)-146a、miR-145、辅助型T细胞17(Th17)/调节型T细胞(Treg)水平及临床意义。回顾性收集2020年6月至2023年6月南通市妇幼保健院收治的200例RSV感染性肺炎患儿的临床资料,将其作为研究组。同时选择同期200例支原体肺炎患儿作为普通肺炎组,200名健康体检儿童作为健康组。通过酶联免疫吸附法检测血清炎性因子[白细胞介素-6(IL-6)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)]水平,RT-qPCR法检测血清miR-146a、miR-145表达水平,流式细胞仪检测Th17/Treg水平,对3组间miR-146a、miR-145、Th17/Treg及血清炎性因子水平进行比较,通过Pearson法分析RSV感染性肺炎患儿miR-146a、miR-145、Th17/Treg与血清炎性因子的相关性,受试者工作特征曲线(ROC)分析miR-146a、miR-145、Th17/Treg对呼吸道合胞病毒感染性肺炎患儿的诊断价值。结果显示,在研究组中miR-146a(2.01±0.58)、miR-145(1.81±0.46)、Th17/Treg(1.09±0.31)、IL-6(7.82±2.11)ng/L及TNF-α(9.82±2.96)ng/L均高于普通肺炎组中miR-146a(1.49±0.42)、miR-145(1.43±0.31)、Th17/Treg(0.77±0.24)、IL-6(5.89±1.32)ng/L、TNF-α(7.34±2.32)ng/L及健康组中miR-146a(1.25±0.19)、miR-145(1.19±0.16)、Th17/Treg(0.38±0.09)、IL-6(4.52±1.04)ng/L、TNF-α(5.39±1.07)ng/L,且普通肺炎组上述指标水平均高于健康组,差异有统计学意义(F=183.543、175.938、617.182、226.657、193.459,P<0.05);在研究组中IFN-γ(14.18±3.25)pg/ml低于对照组(19.52±5.13)pg/ml,而高于健康组(9.77±2.40)pg/ml,差异有统计学意义(F=335.432,P<0.05);Pearson相关性分析结果显示,RSV感染性肺炎患儿miR-146a、miR-145、Th17/Treg与其IL-6、TNF-α均呈正相关(P<0.05),而与IFN-γ均呈负相关(P<0.05);ROC曲线结果显示,miR-146a、miR-145、Th17/Treg诊断RSV感染性肺炎的曲线下面积(AUC)分别为0.767、0.762、0.790,而三者联合检测为0.904。综上,miR-146a、miR-145及Th17/Treg水平在RSV感染性肺炎患儿中呈现高表达状态,且与患儿的炎症反应密切相关,通过对三者联合检测可能对辅助诊断RSV感染性肺炎具有一定应用价值。.