Expression and Clinical Significance of Circulating MiR_130a and MiR_132 in Patients with Severe Traumatic Brain Injury
- Author:
- No author available
- Journal Title:
- Prevention and Treatment of Cardio-Cerebral-Vascular Disease
- Issue:
- 4
- DOI:
- 10.3969/j.issn.1009_816x.2019.04.004
- Key Word:
- 重型颅脑损伤;基因芯片;微小RNA_130a;微小RNA_132;近期预后
Abstract： 目的 探讨颅脑损伤(TBI)患者入院时外周血miR_130a和miR_132水平对病情严重程度的早期诊断价值,以及对重型颅脑损伤(sTBI)患者发病6个月预后的预测价值.方法 选择在我院救治的158例TBI患者和30例健康志愿者作为对照组纳入研究,根据格拉斯昏迷评分(GCS),将TBI患者分为轻度(mTBI)组、中度(msTBI)组和重度(sTBI)组.采用基因芯片技术筛选四组受试对象有表达差异的miRNAs,并筛选靶基因明确的miRNAs进行荧光定量PCR验证.随访6个月,根据格拉斯预后评分(GOS),将患者分为预后良好组和预后不良组.建立受试者工作特征(ROC)曲线确定外周血miRNAs对预后诊断的临界值.结果 经基因芯片分析选择miR_130a和miR_132作为目标miRNA,经荧光定量PCR检测,与对照组受试者相比,三组TBI患者外周血中miR_130a表达均显著上调,同时miR_132表达量显著下调(均P<0.05).而且以sTBI组患者外周血miR_130a水平为最高,miR_132水平为最低.经Spearman相关性分析,TBI患者入院时GCS评分和外周血miR_130a表达呈负相关性(rs=-0.79,P<0.05),而和miR_132表达呈正相关性(rs=0.74,P<0.05).根据6个月随访结果,39例患者预后良好,26例患者预后不良.预后良好组患者外周血miR_130a水平低于预后不良组患者(P<0.05),同时miR_132水平高于预后不良组患者(P<0.05).经ROC曲线分析,入院时外周血miR_130a和miR_132水平对sTBI患者6个月预后预测的ROC曲线下面积(area under curve,AUC)分别为0.74(95％CI 0.57～0.87)、0.70(95％CI 0.63～0.85),差异无统计学意义(P>0.05).而miR_130a和miR_132联合预测mTBI患者预后的ROC曲线AUC明显高于单项指标(P<0.05).结论 TBI患者入院时外周血miR_130a和miR_132水平可早期评估疾病严重程度,并且可作为sTBI患者近6个月预后的早期预测指标.
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