血清miR-134-5p和miR-320a检测联合肺功能指标对煤工尘肺患者的早期诊断价值

doi:10.11958/20221645

天津医药 ›› 2023, Vol. 51 ›› Issue (8): 860-863.doi: 10.11958/20221645

血清miR-134-5p和miR-320a检测联合肺功能指标对煤工尘肺患者的早期诊断价值

熊高才¹(), 杨元凤²^,^△(), 李家松¹, 刘廷谦¹, 何冰冰¹, 刘卓令¹

1 贵州省第三人民医院呼吸及危重症科（邮编550008）
2 贵州中医药大学第二附属医院药学部

收稿日期:2022-10-12 修回日期:2023-02-21 出版日期:2023-08-15 发布日期:2023-08-10
通讯作者: ^△E-mail：369400274@qq.com
作者简介:熊高才（1984），男，主治医师，主要从事尘肺及呼吸系统疾病方面研究。E-mail：1634872832@qq.com
基金资助:
贵州省卫生健康委科学技术基金资助项目(gzwjkj2020-1-184)

Early diagnostic value of serum miR-134-5p and miR-320a combined with pulmonary function index in coal worker pneumoconiosis patients

XIONG Gaocai¹(), YANG Yuanfeng²^,^△(), LI Jiasong¹, LIU Tingqian¹, HE Bingbing¹, LIU Zhuoling¹

1 Department of Respiratory and Critical Care, the Third People's Hospital of Guizhou Province, Guiyang 550008, China
2 Department of Pharmacy, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine

Received:2022-10-12 Revised:2023-02-21 Published:2023-08-15 Online:2023-08-10
Contact: ^△E-mail: 369400274@qq.com

熊高才, 杨元凤, 李家松, 刘廷谦, 何冰冰, 刘卓令. 血清miR-134-5p和miR-320a检测联合肺功能指标对煤工尘肺患者的早期诊断价值[J]. 天津医药, 2023, 51(8): 860-863.

XIONG Gaocai, YANG Yuanfeng, LI Jiasong, LIU Tingqian, HE Bingbing, LIU Zhuoling. Early diagnostic value of serum miR-134-5p and miR-320a combined with pulmonary function index in coal worker pneumoconiosis patients[J]. Tianjin Medical Journal, 2023, 51(8): 860-863.

摘要/Abstract

摘要：

目的探讨血清miR-134-5p和miR-320a联合肺功能指标对尘肺患者早期临床诊断价值。方法选取煤工尘肺（CWP）患者（CWP组）、煤矿接尘体检人群（接尘组）以及同期健康体检人群（对照组）各40例；实时荧光定量PCR（qRT-PCR）法检测各组血清miR-134-5p和miR-320a水平。检测各组受试者的肺功能指标：最大通气量（MVV）、用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、第3秒用力呼气容积（FEV3）、1秒率（FEV1/FVC）、3秒率（FEV3/FVC）、最大呼气中期流量（MMEF）、峰流速（PEF）、75%呼气流速（MEF75）、50%呼气流速（MEF50）、25%呼气流速（MEF25）、残气量/肺总量（TLC）、功能残气量（FRC）和肺泡通气量（VA）；采用Logistic回归分析煤矿接尘相关作业的人群发生CWP的危险因素；采用受试者工作特征（ROC）曲线分析miRNA联合肺功能指标对CWP患者的早期诊断价值。结果对照组、接尘组和CWP组血清miR-134-5p、miR-320a表达水平，MVV、FEV1、FEV1/FVC、MMEF、MEF50、FRC和VA逐渐降低（P<0.05）。多因素Logistic回归分析结果发现FRC降低是煤矿接尘人群发生CWP的独立危险因素（P<0.05）。miR-134-5p和miR-320a联合肺功能指标FRC预测煤矿接尘相关作业的人群发生CWP的诊断效能较高，AUC为0.975（95%CI：0.948~1.000）。结论血清miR-134-5p、miR-320a和肺功能指标FRC联合对早期CWP的临床诊断具有重要参考价值。

关键词: 煤尘肺, 功能残气量, 呼吸功能试验, miR-134-5p, miR-320a

Abstract:

Objective To explore the value of serum miR-134-5p and miR-320a combined with pulmonary function indexes in the early clinical diagnosis of pneumoconiosis. Methods Forty cases of coal workers' pneumoconiosis (CWP), 40 cases of coal mine dust exposed physical examination population and 40 cases of healthy physical examination population in the same period were included in this study. Expression levels of serum miR-134-5p and miR-320a were detected by qRT-PCR assay. Lung function indexes were detected in three groups, including maximum ventilation volume (MVV), forced vital capacity (FVC), forced expiratory volume 1 (FEV1), forced expiratory volume 3 (FEV3), FEV1/FVC, FEV3/FVC, maximum mid-expiratory flow (MMEF), peak expiratory flow (PEF), 75 % maximal expiratory flow (MEF75), 50% maximal expiratory flow (MEF50), 25% maximal expiratory flow (MEF25), residual volume (RV), RV/total lung capacity (TLC), functional residual capacity (FRC) and alveolar ventilation (VA). Logistic regression was used to analyze risk factors of CWP in coal mine dust-related operations. Receiver operating characteristic (ROC) curve was used to analyze the early diagnostic value of miRNA combined with pulmonary function index in patients with CWP. Results The expression levels of serum miR-134-5p, miR-320a, MVV, FEV1, FEV1/FVC, MMEF, MEF50, FRC and VA were decreased gradually in the control group, the dust exposure group and the CWP group (P<0.05). Multiple Logistic regression analysis showed that the decrease of FRC was an independent risk factor for CWP in coal mine dust exposure population (P<0.05). miR-134-5p and miR-320a combined with lung function index FRC showed high diagnostic efficacy in predicting CWP disease in coal mine dust-related operations, with an AUC of 0.975 (95%CI: 0.948-1.000). Conclusion The combination of serum miR-134-5p, miR-320a and lung function index FRC has important reference value for the clinical diagnosis in patients with early CWP.

Key words: anthracosis, functional residual capacity, respiratory function tests, miR-134-5p, miR-320a

中图分类号:

R563.9

图/表 6

参考文献 20

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组别	n	miR-134-5p	miR-320a
对照组	40	1.004（0.793，1.513）	1.041（0.813，1.663）
接尘组	40	0.821（0.582，1.222）^a	0.785（0.662，1.307）^a
CWP组	40	0.168（0.082，0.729）^ab	0.256（0.097，0.882）^ab
χ²		74.325^＊	66.515^＊

组别	n	miR-134-5p	miR-320a
对照组	40	1.004（0.793，1.513）	1.041（0.813，1.663）
接尘组	40	0.821（0.582，1.222）^a	0.785（0.662，1.307）^a
CWP组	40	0.168（0.082，0.729）^ab	0.256（0.097，0.882）^ab
χ²		74.325^＊	66.515^＊

组别	MVV/%	FVC/L	FEV1/%	FEV3/%	FEV1/FVC/%	FEV3/FVC/%	MMEF/%
对照组	87.97±5.65	7.32±1.15	34.09±11.02	34.59（13.55，41.06）	4.71±1.50	4.07±2.15	63.59（51.83，72.99）
接尘组	51.59±8.11^a	7.40±0.83	23.49±6.46^a	27.47（12.06，39.34）	3.20±0.95^a	3.63±2.05	49.85（39.24，60.44）^a
CWP组	45.55±6.17^ab	7.72±1.09	14.23±4.97^ab	25.89（13.34，37.26）	1.95±0.85^ab	3.31±1.80	22.15（18.13，32.06）^ab
F或χ²	464.936^＊＊	0.932	64.757^＊＊	1.436	59.583^＊＊	1.441	73.263^＊＊
组别	PEF/%	MEF75/%	MEF50/%	MEF25/%	RV/TLC/%	FRC/dL	VA/%
对照组	7.22±2.46	33.63（19.84，42.25）	10.14±2.73	54.00±11.82	37.30±9.79	18.50（13.55，25.95）	41.09±13.33
接尘组	6.90±1.73	31.09（19.78，41.31）	7.14±1.90^a	57.77±10.33	38.83±8.01	9.22（6.37，12.54）^a	28.54±7.85^a
CWP组	7.21±1.17	27.65（18.90，36.35）	4.11±1.61^ab	55.83±7.10	38.77±6.16	2.52（1.06，4.17）^ab	16.53±6.35^ab
F或χ²	0.393	2.367	79.892^＊＊	2.008	0.457	84.323^＊＊	64.669^＊＊

组别	MVV/%	FVC/L	FEV1/%	FEV3/%	FEV1/FVC/%	FEV3/FVC/%	MMEF/%
对照组	87.97±5.65	7.32±1.15	34.09±11.02	34.59（13.55，41.06）	4.71±1.50	4.07±2.15	63.59（51.83，72.99）
接尘组	51.59±8.11^a	7.40±0.83	23.49±6.46^a	27.47（12.06，39.34）	3.20±0.95^a	3.63±2.05	49.85（39.24，60.44）^a
CWP组	45.55±6.17^ab	7.72±1.09	14.23±4.97^ab	25.89（13.34，37.26）	1.95±0.85^ab	3.31±1.80	22.15（18.13，32.06）^ab
F或χ²	464.936^＊＊	0.932	64.757^＊＊	1.436	59.583^＊＊	1.441	73.263^＊＊
组别	PEF/%	MEF75/%	MEF50/%	MEF25/%	RV/TLC/%	FRC/dL	VA/%
对照组	7.22±2.46	33.63（19.84，42.25）	10.14±2.73	54.00±11.82	37.30±9.79	18.50（13.55，25.95）	41.09±13.33
接尘组	6.90±1.73	31.09（19.78，41.31）	7.14±1.90^a	57.77±10.33	38.83±8.01	9.22（6.37，12.54）^a	28.54±7.85^a
CWP组	7.21±1.17	27.65（18.90，36.35）	4.11±1.61^ab	55.83±7.10	38.77±6.16	2.52（1.06，4.17）^ab	16.53±6.35^ab
F或χ²	0.393	2.367	79.892^＊＊	2.008	0.457	84.323^＊＊	64.669^＊＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
MVV	-0.003	0.005	0.302	0.583	0.997	0.989~1.006
FEV1	-0.023	0.012	4.076	0.044	0.977	0.955~0.999
FEV1/FVC	-1.527	0.347	19.338	0.000	0.217	0.110~0.429
MMEF	-0.015	0.006	6.880	0.009	0.985	0.974~0.996
MEF50	-0.075	0.040	3.582	0.058	0.928	0.858~1.003
FRC	-0.139	0.040	12.326	0.000	0.870	0.805~0.940
VA	-0.019	0.010	3.636	0.057	0.981	0.962~1.001
miR-134-5p	-7.588	1.764	18.499	0.000	0.001	0.000~0.016
miR-320a	-6.495	1.428	20.681	0.000	0.002	0.000~0.025

血清miR-134-5p和miR-320a检测联合肺功能指标对煤工尘肺患者的早期诊断价值

Early diagnostic value of serum miR-134-5p and miR-320a combined with pulmonary function index in coal worker pneumoconiosis patients

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变量	B	SE	Waldχ²	P	OR	OR 95%CI
FEV1	-0.192	0.165	1.353	0.245	0.825	0.597~1.141
FEV1/FVC	0.452	1.114	0.165	0.685	1.571	0.177~13.952
MMEF	-0.047	0.046	1.034	0.309	0.954	0.872~1.044
FRC	-0.910	0.407	5.003	0.025	0.403	0.181~0.894
miR-134-5p	-1.889	2.909	0.422	0.516	0.151	0.001~45.289
miR-320a	0.025	3.049	0.000	0.994	1.025	0.003~403.930

指标	AUC（95%CI）	敏感度/%	特异度/%	约登指数
miR-134-5p	0.905（0.843~0.966）	72.50	90.00	0.625
miR-320a	0.902（0.839~0.965）	75.00	90.50	0.625
FRC	0.972（0.941~1.000）	90.00	95.00	0.850
联合指标	0.975（0.948~1.000）	95.00	90.00	0.850

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