急性脊髓损伤患者外周血miR-146a和miR-155表达变化及意义

Expression and implications of miR-146a and miR-155 level in peripheral blood of patients with acute spinal cord injury

目的:探讨急性脊髓损伤(ASCI)患者外周血miR-146a和miR-155表达变化,以及与损伤程度的相关性。方法:选取ASCI患者65例,根据ASIA标准分为完全损伤组(n=22)和不完全损伤组(n=43),同期选取脊柱创伤但神经功能正常者26例作为脊髓正常组和健康者40例作为对照组,分别于伤后12、24、36、48和72 h时,对照组于体检当日,利用实时荧光定量PCR技术检测外周血中miR-146a和miR-155表达。结果:与伤后12 h相比,完全损伤组、不完全损伤组和脊髓正常组患者伤后24、36、48和72 h时外周血中miR-146a和miR-155相对表达量均呈先升高后降低,伤后24 h时达最大值,差异均有统计学意义(P<0.05),伤后12、24、36、48和72 h时外周血中miR-146a和miR-155表达量比较:完全损伤组>不完全损伤组>脊髓正常组>对照组,差异均有统计学意义(P<0.05); ROC曲线分析显示,ASCI患者伤后24 h时外周血中miR-146a和miR-155相对表达量在预测完全性损害时,两者联合时,曲线下面积0.976(95%CI:0.945～1.000),灵敏度93.0%,特异度95.5%。结论:ASCI患者外周血中miR-146a和miR-155表达量升高,可作为评估患者病情严重程度的参考指标。

Objective ：To investigate the expression and implications of miR-146a and miR-155 level in peripheral blood of patients with acute spinal cord injury-（ASCI） , and the correlation of the indicators with damage degree. Methods：A total of 65 patients with ASCI were recruited, and were divided into complete injury group（n-22） and incomplete injury group （n-43） by the ASIA criteria. Twenty-six patients of spinal trauma with intact neurological function were enrolled in the con＇esponding period as the normal spinal cord group and 40 healthy subjects were recruited as controls. Real-time fluores- cence quantitative PCR was performed to determine the peripheral blood miR-146a and mill-155 levels at 12,24,36,48 and 72 h after injury, respectively,in patients in the injury group as well as at the very day in controls undergoing medical examination. Results：Peripheral blood levels of miR-146a and mill-155 tended to increase, then went down at 24,36,48 and 72 h after injury in patients with either complete or incomplete spinal injury, compared to the level at 12 h, and the level was peaked at the 24 h after injury. The difference was significant （P〈0.05）. By comparison of peripheral blood mill-146a and mill-155 expression at 12,24,36,48 and 72 h after injury, the level was ranked by：the complete injury group the incomplete injury group the normal spi- nal cord group the control group. ROC curve analysis showed that the relative expression of miR-146a and miR-155 in peripheral blood in patients with AS- CI for predicting complete damage was 0.976 （ 95 % CI ： 0.945-1.000） under the curve area, with sensitivity of 93.0% and specificitu of 95.5 %, when the two indicators were jointly considered. Conclusion：Patients of ASCI have up-regulated expression of miR-146a and miR-155 in peripheral blood,which may be used as reference indexes to assess the severity of the patient＇s condition.