婴儿胆汁淤积性肝病血清lncRNA-H19和FOXO1表达及其临床意义

摘要/Abstract

摘要： 目的探讨婴儿胆汁淤积性肝病(ICH)血清lncRNA-H19和叉头转录因子O1(FOXO1)表达及其临床意义。方法纳入2017年4月至2022年4月在北京友谊医院接受治疗的ICH患儿100例。根据症状体征的积分分为轻度(＜10分)79例、中重度(≥10分)21例。另纳入同期发生黄疸但未发现肝病的婴儿100例。采用荧光定量PCR测定受试婴儿血清lncRNA-H19、FOXO1水平;采用logistic多因素回归分析评估发生ICH的影响因素;采用受试者工作特征曲线下面积(AUC)评价血清lncRNA-H19、FOXO1水平及其联合对ICH的诊断价值。结果相较于非ICH组,ICH组lncRNA-H19水平升高(1.39±0.43比1.00±0.33),FOXO1水平降低(0.74±0.24比1.01±0.32),差异有统计学意义(t=7.195、6.750,均P<0.05)。与轻度组比较,中重度组的lncRNA-H19水平升高(1.78±0.47比1.29±0.32),FOXO1水平降低(0.48±0.13比0.81±0.22),差异有统计学意义(t=5.610、6.561,P<0.05)。Logistic分析结果显示,lncRNA-H19(OR:1.715,95%CI:1.212~2.426)是ICH的独立危险因素,高水平FOXO1(OR:0.593,95%CI:0.374~0.940)是ICH的独立保护因素(P<0.05)。血清lncRNA-H19、FOXO1水平及二者联合诊断ICH严重程度的AUC分别为0.758、0.750、0.829,二者联合的诊断效能显著高于单独预测(Z=1.589、1.738,P<0.05)。结论 ICH患儿血清lncRNA-H19水平升高,FOXO1水平降低,二者与ICH病情程度关系密切,均有望成为ICH发生的预测因子。

关键词: 婴儿胆汁淤积性肝病, lncRNA-H19, 叉头转录因子O1, 诊断

Abstract: Objective To investigate the expression and clinical significance of serum lncRNA-H19 and forkhead transcription factor O1 (FOXO1) levels in children with infantile cholestatic hepatopathy (ICH). Methods 100 children with ICH who received treatment at our institute from April 2017 to April 2022 were included as the study subjects (ICH group). According to the score of clinical symptoms and signs, they were further divided into mild group (<10 points, 79 cases) and moderate and severe group (≥10 points, 21 cases). Another 100 infants who developed jaundice in the same period without liver disease were included as control group. The serum levels of lncRNA-H19 and FOXO1 in children were measured by fluorescence quantitative real time PCR; logistic multiple factor regression was applied to analyze the influencing factors of patients with ICH; the serum levels of lncRNA-H19, FOXO1 and their combined diagnostic value for ICH were evaluated by the subject working characteristic (ROC) curve. Results Compared with the control group, the levels of lncRNA-H19 (1.39±0.43 vs. 1.00±0.33) in ICH group were obviously higher, the levels of FOXO1 (0.74±0.24 vs. 1.01±0.32) were obviously lower, and the difference were statistically significant (t=7.195, 6.750, P<0.05). Compared with the mild group, lncRNA-H19 (1.78±0.47 vs. 1.29±0.32) levels in the moderate and severe group were significantly higher , FOXO1 (0.48±0.13 vs. 0.81±0.22) levels were significantly lower (t=5.610, 6.561, P<0.05). Logistic analysis showed that lncRNA-H19 (OR: 1.715, 95%CI:1.212~2.426) were independent risk factors for ICH, and high levels of FOXO1 (OR: 0.593, 95%CI:0.374~0.940) were independent protective factors for ICH (P<0.05). ROC results showed that the AUC of the severity of the levels of lncRNA-H19 and FOXO1 in serum and their combination for ICH was 0.758, 0.750 and 0.829, respectively, the AUC of combined prediction was obviously higher than the two independent prediction (Z=1.589, 1.738, P<0.05). Conclusion The level of serum lncRNA-H19 is increased and the level of FOXO1 is decreased in children with ICH, they are closely related to the severity of ICH and are expected to become predictors of ICH.

Key words: Infantile cholestatic hepatopathy, LncRNA-H19, Forkhead transcription factor O1, Diagnosis

方文征, 李道醒, 左力. 婴儿胆汁淤积性肝病血清lncRNA-H19和FOXO1表达及其临床意义[J]. 肝脏, 2026, 31(4): 578-582.

FANG Wen-zheng, LI Dao-xing, ZUO Li. The expression and clinical significance of serum lncRNA-H19 and FOXO1 levels in children with infantile cholestatic hepatopathy[J]. Chinese Hepatolgy, 2026, 31(4): 578-582.

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