血清lncRNA THRIL、lncRNA NEAT1与新生儿肺炎病情程度及预后的相关性

doi:10.3969/j.issn.1006-5725.2026.02.019

摘要/Abstract

摘要：

目的探究血清长链非编码RNA肿瘤坏死因子相关异种核糖核蛋白L（lncRNA THRIL）、长链非编码RNA核富集转录本1（lncRNA NEAT1）与新生儿肺炎病情程度、预后的关系。方法选取2022年8月至2024年8月河北医科大学第四医院收治的120例新生儿肺炎患儿为观察组，根据病情程度分为轻症组（42例）、中症组（40例）和重症组（38例）；根据治疗2周后预后情况分为预后良好组（86例）和预后不良组（34例）。同时，选取同期在医院进行健康体检的120例健康新生儿，将其设为对照组。采用实时荧光定量PCR法测定受试新生儿血清lncRNA THRIL、lncRNA NEAT1水平；收集新生儿肺炎患儿临床资料，并检测免疫炎症指标［血清可溶性髓样细胞触发受体-1（sTREM-1）、可溶性白细胞介素2受体（sIL-2R）］。对于新生儿肺炎患儿预后不良的影响因素，采用logistic回归分析进行识别与验证；针对血清lncRNA THRIL和lncRNA NEAT1对患儿不良预后的预测作用，通过受试者工作特征（ROC）曲线分析予以评价，明确两者单独及联合预测的临床价值。结果观察组血清lncRNA THRIL、lncRNA NEAT1水平与对照组相比显著升高（P < 0.05）；血清lncRNA THRIL、lncRNA NEAT1水平随着新生儿肺炎病情的加重而逐渐升高（P < 0.05）；与预后良好组相比，预后不良组剖腹产占比、血清sTREM-1、sIL-2R、lncRNA THRIL、lncRNA NEAT1水平均显著升高（P < 0.05）；血清sIL-2R、lncRNA THRIL、lncRNA NEAT1为新生儿肺炎患儿预后不良的独立危险因素（P < 0.05）；血清lncRNA THRIL、lncRNA NEAT1、二者联合预测新生儿肺炎患儿发生预后不良的曲线下面积（AUC）分别为0.772、0.808、0.930，二者联合预测的AUC显著高于各指标单独预测的AUC（Z_{二者联合-lncRNA THRIL} = 2.347、Z_{二者联合-lncRNA NEAT1} = 2.217，P = 0.019、0.027）。结论新生儿肺炎患儿血清lncRNA THRIL、lncRNA NEAT1水平均明显升高，二者均是新生儿肺炎预后不良的危险因素，二者联合对新生儿肺炎患儿的预后有较好的预测效果。

关键词: 新生儿肺炎, 长链非编码RNA肿瘤坏死因子相关异种核糖核蛋白L, 长链非编码RNA核富集转录本1, 病情程度, 预后

Abstract:

Objective To investigate the relationship between serum long non-coding RNA tumor necrosis factor related heterologous ribonucleoprotein L （lncRNA THRIL） and long non-coding RNA nuclear enriched abundant transcript 1 （lncRNA NEAT1） and the severity and prognosis of neonatal pneumonia. Methods A total of 120 cases of neonatal pneumonia treated at the Fourth Hospital of Hebei Medical University from August 2022 to August 2024 were selected as the observation group. These cases were divided into the mild-disease group （42 cases）， the moderate-disease group （40 cases）， and the severe-disease group （38 cases） based on the severity of the disease. According to the prognosis after 2 weeks of treatment， the pediatric patients were classified into the good-prognosis group （86 cases） and the poor-prognosis group （34 cases）. Meanwhile， 120 healthy neonates who underwent physical examinations at the hospital during the same period were selected as the control group. The serum levels of lncRNA THRIL and lncRNA NEAT1 in the tested neonates were measured using real-time fluorescence quantitative polymerase chain reaction （PCR）. The clinical data of neonates with pneumonia were collected， and the immune inflammatory markers， namely soluble triggering receptor expressed on myeloid cells-1 （sTREM-1） and soluble interleukin-2 receptor （sIL-2R）， were detected. Logistic regression analysis was employed to identify and verify the influencing factors associated with poor prognosis in neonates with pneumonia. Considering the predictive effect of serum lncRNA THRIL and lncRNA NEAT1 on the poor prognosis of these children， receiver operating characteristic （ROC） curve analysis was conducted to evaluate the clinical value of each lncRNA individually and their combined value. Results The serum levels of lncRNA THRIL and lncRNA NEAT1 in the observation group were significantly higher than those in the control group （P < 0.05）. The serum levels of lncRNA THRIL and lncRNA NEAT1 gradually increased as neonatal pneumonia worsened （P < 0.05）. When compared with the good-prognosis group， the proportion of cesarean section and the levels of serum sTREM-1， sIL-2R， lncRNA THRIL， and lncRNA NEAT1 in the poor-prognosis group were significantly elevated （P < 0.05）. Serum sIL-2R， lncRNA THRIL， and lncRNA NEAT1 were identified as independent risk factors for poor prognosis in neonates with pneumonia （P < 0.05）. The area under the curve （AUC） values of serum lncRNA THRIL， lncRNA NEAT1， and their combination in predicting the poor prognosis of neonatal pneumonia were 0.772， 0.808， and 0.930， respectively. Moreover， the AUC of the combination of the two was significantly higher than that of each index alone （Z_{combination-lncRNA THRIL} = 2.347， Z_{combination-lncRNA NEAT1} = 2.217， P = 0.019， 0.027）. Conclusion Serum levels of lncRNA THRIL and lncRNA NEAT1 are significantly elevated in neonates with pneumonia. Both lncRNA THRIL and lncRNA NEAT1 serve as risk factors for the poor prognosis of neonatal pneumonia， and their combination exhibits a favorable predictive effect on the prognosis of neonates with pneumonia.

Key words: neonatal pneumonia, long non-coding RNA tumor necrosis factor related heterologous ribonucleoprotein L, long non-coding RNA nuclear enriched abundant transcript 1, severity of illness, prognosis

中图分类号:

R722.13⁺5

刘鑫,张宏蕊,沈颖,刁玉巧,樊涛. 血清lncRNA THRIL、lncRNA NEAT1与新生儿肺炎病情程度及预后的相关性[J]. 实用医学杂志, 2026, 42(2): 327-333.

Xin LIU,Hongrui ZHANG,Ying SHEN,Yuqiao DIAO,Tao FAN. Correlation of serum lncRNA THRIL， lncRNA NEAT1 with the severity and prognosis of neonatal pneumonia[J]. The Journal of Practical Medicine, 2026, 42(2): 327-333.

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引物名称	引物序列
lncRNA THRIL	上游引物：5′-AACTTCACAGGAACACTACACAAGA-3′
	下游引物：5′-TAGGCAACAGAGCAAGACTTCATC-3′
lncRNA NEAT1	上游引物：5′-TGTCCCTCGGCTATGTCAGA-3′
	下游引物：5′-GAGGGGACGTGTTTCCTGAG-3′
甘油醛-3-磷酸脱氢酶	上游引物：5′-GAGTCCACTGGCGTCTTCAC-3′
	下游引物：5′-ATCTTGAGGCTGTTGTCATATTCT-3′

组别	例数	lncRNA THRIL	lncRNA NEAT1
对照组	120	1.12 ± 0.27	1.05 ± 0.12
观察组	120	2.28 ± 0.49	2.22 ± 0.51
t值		22.713	24.463
P值		< 0.001	< 0.001

组别	例数	lncRNA THRIL	lncRNA NEAT1
轻症组	42	1.51 ± 0.29	1.12 ± 0.34
中症组	40	2.35 ± 0.45^?	2.21 ± 0.48^?
重症组	38	3.05 ± 0.76^?#	3.46 ± 0.76^?#
F值		85.161	182.103
P值		< 0.001	< 0.001

项目	预后良好组（n = 86）	预后不良组（n = 34）	t/χ² 值	P值
日龄（x ± s）/d	12.66 ± 2.37	12.34±2.23	0.677	0.499
性别			0.859	0.354
男	51（59.30）	17（50.00）
女	35（40.70）	17（50.00）
出生体质量			2.116	0.146
< 3 kg	33（38.37）	18（52.94）
≥ 3 kg	53（61.63）	16（47.06）
出生季节			0.119	0.730
春秋季	46（53.49）	17（50.00）
冬夏季	40（46.51）	17（50.00）
分娩方式			7.694	0.006
顺产	59（68.60）	14（41.18）
剖腹产	27（31.40）	20（58.82）
病因			0.479	0.489
吸入性肺炎	49（56.98）	17（50.00）
感染性肺炎	37（43.02）	17（50.00）
sTREM-1（x ± s）/（ng/L）	86.77 ± 19.48	103.52 ± 20.51	4.181	< 0.001
sIL-2R（x ± s）/（ng/L）	328.62 ± 51.36	375.44 ± 57.65	4.345	< 0.001

组别	例数	lncRNA THRIL	lncRNA NEAT1
预后良好组	86	1.98 ± 0.34	1.93 ± 0.42
预后不良组	34	3.04 ± 0.87	2.96 ± 0.74
t值		9.635	9.605
P值		< 0.001	< 0.001