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目的探讨肺结核患者外周血微小RNAs(miRNA)分子表达水平及临床意义,为临床早期诊断提供参考依据。方法选择2012年1月—2014年12月收治的30例肺结核患者、30例潜伏结核感染患者及30例健康体检者作为研究对象,采用反转录-荧光定量PCR检测活动性肺结核患者(活动组)、潜伏结核感染患者(潜伏组)及健康体检者(对照组)血浆miR-29a、miR-21-5p和miR-155-5p的表达水平,对其进行统计学处理及ROC曲线分析。结果活动组血浆miR-29a、miR-21-5p和miR-155-5p表达水平分别为2.11±0.43、4.74±1.29、3.17±0.65,均显著高于对照组和潜伏组(P<0.05);潜伏组血浆miR-155-5p表达水平为0.96±0.28,显著高于对照组(P<0.05);潜伏组血浆miR-29a、miR-21-5p与对照组比较差异无统计学意义(P>0.05);miR-29a、miR-21-5p、miR-155-5p诊断活动性肺结核的ROC曲线图下面积分别为0.732、0.846和0.914,敏感度和特异度分别为80.0%和69.2%、73.3%和82.9%、86.7%和90.0%。结论在活动性肺结核及潜伏结核感染患者中血浆miR-29a、miR-21-5p和miR-155-5p表达水平均明显升高,可作为诊断活动性肺结核的重要指标,值得临床重视。
Objective To investigate the expression of microRNA (miRNA) molecules in peripheral blood of patients with pulmonary tuberculosis and its clinical significance, and provide a reference for early clinical diagnosis. Methods Thirty patients with tuberculosis, 30 patients with latent tuberculosis infection and 30 healthy subjects admitted from January 2012 to December 2014 were enrolled in this study. Patients with active pulmonary tuberculosis (active group ), Latent tuberculosis infection (latent group) and healthy subjects (control group). The expression of miR-29a, miR-21-5p and miR-155-5p were analyzed statistically and ROC curve analysis. Results The plasma levels of miR-29a, miR-21-5p and miR-155-5p in active group were 2.11 ± 0.43, 4.74 ± 1.29 and 3.17 ± 0.65, respectively, which were significantly higher than those in control group and latent group (P <0.05). The expression level of miR-155-5p in the latent group was 0.96 ± 0.28, which was significantly higher than that in the control group (P <0.05). There was no significant difference in the plasma levels of miR-29a and miR-21-5p between the latent group and the control group (P> 0.05). The area under the ROC curve of miR-29a, miR-21-5p and miR-155-5p in diagnosing active pulmonary tuberculosis were 0.732, 0.846 and 0.914, respectively. The sensitivity and specificity were 80.0% and 69.2%, respectively, and 73.3 % And 82.9%, 86.7% and 90.0% respectively. Conclusion The expression of miR-29a, miR-21-5p and miR-155-5p in patients with active pulmonary tuberculosis and latent tuberculosis infection are significantly increased, which can be used as an important index in diagnosis of active pulmonary tuberculosis and deserve clinical attention.