微小RNA-124-3p与自发性脑出血患者血肿体积、病情严重程度的关系

Relationship between microRNA-124-3p and the volume and severity of intracerebral hemorrhage

目的研究微小RNA(miR)-124-3p与自发性脑出血患者血肿体积、病情严重程度间的关系,以及在预测患者预后中的价值。方法检测63例脑出血患者发病24 h内及50例健康志愿者(对照组)的外周血miR-124-3p水平。脑出血患者分别在发病1 d内及4 d时行头颅CT检查,测定脑血肿和水肿体积。分析血浆miR-124-3p水平与脑出血患者血肿、水肿体积及病情严重程度的相关性;并绘制ROC曲线,分析血浆miR-124-3p水平预测脑出血患者院内死亡的价值。结果脑出血组患者中合并高血压的比例和血白细胞计数均显著高于对照组(均P<0.001)。头颅CT检查示,脑出血患者发病4 d时的脑水肿体积较发病1 d内显著增大(P<0.05),发病4 d与发病1 d内的脑血肿体积相比,差异无统计学意义(P>0.05)。血浆miR-124-3p水平与脑出血患者发病1 d内和发病4 d的血肿、水肿体积及入院时ICH-FOS评分均呈正相关(r=0.45~0.78,均P<0.05)。脑出血患者中院内死亡患者22例,其血浆miR-124-3p水平显著高于存活患者(P<0.001)。ROC曲线分析示,血miR-124-3p相对表达量超过2.87时,预测患者院内死亡的价值较高,其曲线下面积(AUC)为0.794(95%CI 0.673~0.915),诊断灵敏度、特异度分别为95.5%和56.1%。结论脑出血患者的外周血miR-124-3p水平异常升高,且与患者的血肿体积、脑水肿体积及病情严重程度均呈正相关,在预测脑出血患者院内死亡中具有较高的价值。

Objective To investigate the relationship between microRNA(miR)-124-3p and the volume and severity of intracerebral hemorrhage(ICH).Methods The levels of miR-124-3p in peripheral blood of 63patients with ICH and 50 healthy volunteers(control group)were measured.Patients with ICH were examined by CT within 1 day and 4 days after onset,and the volumes of cerebral hematoma and edema were measured.The correlation between plasma miR-124-3p level and hematoma,edema volume and severity of ICH was analyzed;ROC curve was drawn to analyze the value of plasma miR-124-3p level in predicting in-hospital death in patients with ICH.Results The proportion of patients with hypertension and blood leukocyte count in ICH group were significantly higher than those in control group(all P<0.001).Cranial CT examination showed that the volume of brain edema in patients with ICH at the 4 th day of onset was significantly larger than that within the 1 st day of onset(P<0.05).There was no significant difference in the volume of brain hematoma at the 4 th day of onset compared with that within the 1 st day of onset(P>0.05).The level of plasma miR-124-3p was positively correlated with the volume of hematoma and edema within 1 day and 4 days of onset and ich-fos score at admission(r=0.45~0.78,all P<0.05).In 22 patients with ICH,the level of plasma miR-124-3p was significantly higher than that of surviving patients(P<0.001).ROC curve analysis showed that when the relative expression of blood miR-124-3p exceeded 2.87,it was of high value in predicting hospital death.The area under the curve(AUC)was 0.794(95%CI 0.673~0.915),and the diagnostic sensitivity and specificity were95.5%and 56.1%respectively.Conclusions The level of miR-124-3p in peripheral blood of patients with ICH increases abnormally,and is positively correlated with the volume of hematoma,the volume of brain edema and the severity of the disease.It has high value in predicting the inhospital death of patients with ICH.