颅脑创伤后挫伤灶边缘水肿区皮层脑组织miRNA-21表达及预后相关性研究

Expression of miRNA-21 in edematous cortex tissues around contusions after traumatic brain injury and its correlation with prognosis

目的：探讨miRNA-21在创伤后皮层脑组织中的表达及其与颅脑创伤患者预后的关系。方法分析江苏大学附属昆山医院2011年12月～2013年12月期间行手术治疗的122例颅脑创伤患者的临床资料，男性99例，女性23例；年龄17～84岁，平均（42.19±14.33）岁。采用实时定量逆转录聚合酶链反应检测上述患者创伤后颞叶皮层脑组织标本中miRNA-21的水平。依据miRNA-21的相对表达量将患者分为两组。应用χ2检验分析miRNA-21表达水平与各临床参数的关系；采用Kaplan-Meier法分析miRNA-21表达与颅脑创伤患者生存期之间的关系；采用Cox风险比例模型分析各个协变量的联合效应。结果 miRNA-21的表达量与患者预后相关（χ2＝4.006，P＝0.045），与患者年龄（χ2＝2.941，P＝0.230）、性别（χ2＝2.625，P＝0.105）、入院时格拉斯哥昏迷评分（GCS）（χ2＝1.425，P＝0.490）、致伤原因（χ2＝2.940，P＝0.816）及颅脑创伤类型（χ2＝0.679，P＝0.712）无关；生存分析显示miRNA-21高表达组患者生存期显著高于低表达组（χ2＝9.723，P＝0.002）。 Cox风险比例模型分析显示miRNA-21表达可作为颅脑创伤患者预后的标志。结论 miRNA-21的表达增高提示颅脑创伤患者预后较好，为预测患者病情转归提供一定依据。

Objective To explore the expression of miRNA-21 in traumatic brain injury tissues and its cor-relation with prognosis.Methods The clinical characteristics of 122 patients[99 were male and 23 were female with an average age of （42.19 ±14.33） years（17-84 years）] who underwent surgery in our hospital from Dec. 2011 to Dec.2013 were retrospectively analyzed.Real-time PCR was used to detect the expression of miRNA-21.The patients were divided into two groups according to the relative expression of miRNA-21.Chi-square test was uti-lized to analyze the relationship between miRNA-21 expression and clinical features.Survival curves were plotted by using the Kaplan-Meier method and compared by the Log-rank test.A Cox proportional hazard regression model was applied to examine the joint effect of covariants.Results The expression of miRNA-21 was associated with progno-sis （χ^2 =4.006,P=0.045）.No statistical significance was observed between the expression of miRNA-21 and the clinical parameters,including age（χ^2 =2.941,P =0.230）,gender（χ^2 =2.625,P =0.105）,GCS at admission （χ^2 =1.425,P=0.490）,injury causes（χ^2 =2.940,P=0.816） and traumatic brain injury type（χ^2 =0.679,P=0.712 ） .Kaplan-Meier analysis showed that high expression of miRNA-21 was closely associated with a longer sur-vival time （χ^2 =9.723,P=0.002）.Both univariate and multivariate analyses demonstrated that miRNA-21 ex-pression might be a good prognostic marker of traumatic brain injury patients.Conclusion Our results indicate that high-regulation of miRNA-21 is associated with good prognosis of patients with traumatic brain injury and may provide some evidences for the prediction of the prognosis.