微小RNA-124在急性脊柱创伤所致急性脊髓损伤中的诊断价值

Diagnostic Value of miR-124 in Acute Spinal Cord Injury Caused by Acute Spinal Trauma

目的探讨微小RNA-124(miR-124)对急性脊柱创伤所致急性脊髓损伤的诊断价值。方法选取2014年9月—2015年9月在郑州大学第一附属医院急诊入院的45例急性脊柱创伤患者,并按照脊髓损伤神经学分类国际标准中的美国脊髓损伤协会残损分级(AISA分级)将患者分为脊髓完全损伤组(AISA分级A级)15例、脊髓不完全损伤组(AISA分级B、C、D级)15例、神经功能正常组(AISA分级E级)15例,另选取同期入院的急性四肢创伤患者15例为对照组。抽取各组患者创伤后24 h内外周静脉血并对其血浆miR-124水平及血清肿瘤坏死因子α(TNF-α)水平进行测定。结果各组间miR-124、TNF-α水平比较,差异有统计学意义(P<0.05)。脊髓完全损伤组、脊髓不完全损伤组的miR-124、TNF-α水平均高于神经功能正常组与对照组(P<0.05)。患者创伤后24 h外周静脉血miR-124、TNF-α诊断急性脊髓损伤的受试者工作特征(ROC)曲线下面积分别为0.948[95%CI(0.890,1.000)]、0.770[95%CI(0.641,0.879)]。结论 miR-124诊断急性脊髓损伤的特异度要优于TNF-α,今后可将miR-124作为诊断急性脊柱创伤后急性脊髓损伤的潜在检测标志物。

Objective To investigate the diagnostic value of microRNA - 124 （miR - 124）in acute spinal cord injury （SCI）caused by acute spinal trauma. Methods The subjects enrolled in this study were 45 patients with acute spinal trauma and 15 patients with acute limb trauma admitted to Emergency Medicine Department of the First Affiliated Hospital of Zhengzhou University from September 2014 to September 2015. In accordance with the SCI level evaluated by American Spinal Injury Association （ASIA）Impairment Scale in International Standards for Neurological Classification of Spinal Cord Injury,the patients with acute spinal trauma were divided into complete SCI group （ASIA grade A,n = 15）and incomplete SCI group （ASIA grade B,C,D,n = 15）,normal nerve function group （ASIA grade E,n = 15）. The patients with acute limb fracture were set as the control group. Peripheral venous blood was taken from the patients in each group within 24 hours after injury and the levels of plasma miR - 124 and serum tumor necrosis factor - alpha （TNF-α）were measured. Results Significant differences in miR - 124 as well as in TNF-α levels were found between the groups （P 〈 0. 05）. Levels of both miR - 124 and TNF-α were higher in the complete SCI group than in normal nerve function group and control group （P 〈 0. 05）. Incomplete SCI group had higher levels of both miR - 124 and TNF-α than the normal nerve function group and control group （P 〈 0. 05）. The area under the curve （AUC）of receiver operating characteristic （ROC）of miR - 124,TNF-α at 24h after injury for diagnosing acute SCI was 0. 948 〔95% CI （0. 890,1. 000）〕,0. 770 〔95% CI （0. 641,0. 879）〕respectively. Conclusion The specificity of miR - 124 for the diagnosis of acute SCI due to spinal trauma is better than that of TNF-α. Therefore,in the future,miR - 124 can be used as a potential marker for the diagnosis of the disease.