| Objective: To analyze the expression of serum long non-coding RNA MEG3 (lncRNA MEG3) and microRNA-424-5p (miR-424-5p) in children with acute respiratory distress syndrome (ARDS) and their relationship with the severity and prognosis of the disease. Methods: 263 children with ARDS admitted to our hospital from June 2021 to June 2023 were selected as observation group, observation group were divided into mild group (n=101), moderate group (n=105) and severe group (n=57) according to the oxygenation index (OI), observation group were divided into survival group (n=167) and death group (n=96) according to the prognosis. Another 160 children who had health checkups in our hospital during the same period were selected as control group. The levels of serum lncRNA MEG3 and miR-424-5p in control group and observation group were compared. The levels of serum lncRNA MEG3 and miR-424-5p in mild group, moderate group and severe group were compared. The correlation between serum lncRNA MEG3, miR-424-5p levels and the severity of the disease in children were analyzed by Pearson correlation analysis. The influencing factors of death in children with ARDS were analyzed by univariate and multivariate COX risk regression models. The predictive value of serum lncRNA MEG3, miR-424-5p for death in children with ARDS were analyzed by receiver operating characteristic (ROC) curve. Results: Compared with control group, the serum lncRNA MEG3 level in observation group was significantly lower, and miR-424-5p level was significantly higher (P<0.05). Compared with mild group and moderate group, the serum lncRNA MEG3 level in severe group was significantly lower, the miR-424-5p level and OI were significantly higher (P<0.05). Compared with mild group, the level of lncRNA MEG3 in moderate group was significantly decreased, and the level of miR-424-5p and OI were significantly increased (P<0.05). Serum lncRNA MEG3 was negatively correlated with OI, and serum miR-424-5p was positively correlated with OI (P<0.05). OI, miR-424-5p, interleukin-6 (IL-6), interleukin-17 (IL-17) and tumor necrosis factor-α (TNF-α) were independent risk factors affecting the prognosis of children with ARDS, and lncRNA MEG3 was an independent protective factor affecting the prognosis of children with ARDS (P<0.05). Serum lncRNA MEG3 and miR-424-5p had certain predictive value for death in children with ARDS, and the area under the curve (AUC) predicted by combined detection was 0.869, which was higher than 0.714 and 0.727 predicted by the two alone (P<0.05). Conclusion: Serum lncRNA MEG3 and miR-424-5p are correlated with the severity of ARDS in children, and can be used as prognostic indicators for children with ARDS. |
