2025 年第 12 期 第 20 卷

新生儿败血症患儿血清微小RNA-155表达水平及其与辅助性T细胞17/调节性T细胞平衡的相关性研究

Expression level of serum microRNA-155 and its correlation with the balance of T helper cell 17/regulatory T cell in children with neonatal septicemia

作者：黄青兰1陶杰2刘凡1鲍萱1鄢晓宁1严争1

英文作者：Huang Qinglan1 Tao Jie2 Liu Fan1 Bao Xuan1 Yan Xiaoning1 Yan Zheng1

单位：1福建医科大学附属福州市第一总医院新生儿科，福州350009；2上海市公共卫生临床中心基础研究部，上海200083

英文单位：1Department of Neonatology Fuzhou First General Hospital Affiliated with Fujian Medical University Fuzhou 350009 China; 2Department of Basic Research Shanghai Public Health Clinical Center Shanghai 200083 China

关键词：新生儿败血症；微小RNA-155；辅助性T细胞17/调节性T细胞平衡；炎症反应

英文关键词：Neonatalsepticemia;MicroRNA-155;Thelpercell17/regulatoryTcellbalance;Inflammatoryresponse

• 摘要：

• 目的 研究新生儿败血症血清微小RNA（miR）-155表达水平，并探讨其与辅助性T细胞17/调节性T细胞（Th17/Treg）平衡的相关性。方法 选取2023年1—12月在福建医科大学附属福州市第一总医院新生儿科收治的24例新生儿败血症患儿为败血症组，另选取同期在本院分娩的健康新生儿22例作为对照组。收集并比较2组新生儿的一般临床资料和实验室检测检查指标，通过实时荧光定量聚合酶链反应法检测血清miR-155水平，通过流式细胞仪检测外周血Th17和Treg水平。使用受试者工作特征（ROC）曲线评估血清miR-155对新生儿败血症诊断效能，并通过Pearson法分析血清miR-155和外周血Th17、Treg和Th17/Treg比值的相关性。结果 败血症组患儿母亲围产期感染比例、外周血白细胞计数、中性粒细胞百分比、C反应蛋白、白细胞介素6、降钙素原、血乳酸水平均显著高于对照组（均P<0.05），10 min Apgar评分、外周血总胆红素、直接胆红素以及间接胆红素水平均显著低于对照组（均P<0.05）。败血症组新生儿miR-155表达水平、Th17水平和Th17/Treg比值均显著高于对照组，而外周血Treg水平显著低于对照组［（1.47±0.27）比（1.00±0.35）、（3.16±0.89）%比（1.43±0.42）%、（15.36±4.54）比（2.74±1.07）、（0.21±0.09）%比（0.58±0.18）%］（均P<0.001）。血清miR-155诊断新生儿败血症患儿的曲线下面积值为0.845。败血症组患儿血清miR-155与C反应蛋白、白细胞介素6、降钙素原、外周血Th17、Th17/Treg比值均呈正相关（均P<0.05）。结论 新生儿败血症患儿血清miR-155和外周血Th17/Treg细胞比例均显著升高，并且二者呈显著正相关，共同促进新生儿败血症外周血炎症反应。

• Objective To study the expression level of serum microRNA (miR)-155 in children with neonatal septicemia, and to explore its correlation with the balance of T helper cell 17/ regulatory T cell (Th17/Treg). Methods A total of 24 children with neonatal septicemia admitted to the Department of Neonatology, Fuzhou First General Hospital Affiliated with Fujian Medical University from January to December 2023 were selected as the sepsis group, and 22 healthy neonates delivered in the same hospital during the same period were selected as the control group. The general clinical data and laboratory test indicators of the two groups were collected and compared. The level of serum miR-155 was detected by real-time fluorescent quantitative polymerase chain reaction, and the levels of Th17 and Treg in peripheral blood were detected by flow cytometry. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of serum miR-155 for neonatal sepsis, and the correlation between serum miR-155 and Th17, Treg and Th17/Treg ratio in peripheral blood was analyzed by Pearson method. Results The proportion of mothers with perinatal infection, peripheral white blood cell count, percentage of neutrophils, C-reactive protein, interleukin-6, procalcitonin, and blood lactic acid levels in the sepsis group were significantly higher than those in the control group (all P<0.05). The 10 min Apgar score, peripheral blood total bilirubin, direct bilirubin and indirect bilirubin levels were significantly lower than those of the control group (all P<0.05). The expression level of miR-155, Th17 level and Th17/Treg ratio of neonates in sepsis group were significantly higher than those in control group, while the peripheral blood Treg level was significantly lower than that in control group ［(1.47±0.27) vs (1.00±0.35), (3.16±0.89)% vs (1.43±0.42)%, (15.36±4.54) vs (2.74±1.07), (0.21±0.09)% vs (0.58±0.18)%］(all P<0.001). The area under the curve value of serum miR-155 in the diagnosis of neonatal sepsis was 0.845. In the sepsis group, serum miR-155 was positively correlated with C-reactive protein, interleukin-6, procalcitonin, Th17 in peripheral blood and Th17/Treg ratio (all P<0.05). Conclusion Serum miR-155 and the proportion of Th17/Treg cells in peripheral blood of children with neonatal septicemia are significantly increased, and there is a significant positive correlation between them, and they jointly promote the inflammatory response in peripheral blood of neonates with sepsis.