创伤性脑损伤患者高压氧治疗后血清miR-3195、miR-328-5p和miR-6867-5p水平及其与预后的关系

The levels of miR-3195,miR-328-5p,and miR-6867-5p after hyperbaric oxygen therapy in patients with traumatic brain injury and their relationships with prognosis

目的探讨创伤性脑损伤患者高压氧治疗后血清miR-3195、miR-328-5p和miR-6867-5p水平及其与预后的关系。方法选取2018年5月至2020年8月在山西医科大学第一医院就诊的124例创伤性脑损伤患者作为研究对象,根据患病后6个月患者的格拉斯哥预后评分(GOS),将其分为预后良好组(n=75)和预后不良组(n=49)。用实时荧光定量PCR法检测高压氧治疗前(T1)及高压氧治疗1个月后(T2),患者血清miR-3195、miR-328-5p和miR-6867-5p的表达水平;通过受试者工作特征(ROC)曲线和Logistic回归分析评估这3种指标对创伤性脑损伤患者高压氧治疗预后的评价效能及其与预后的关系。结果预后良好组患者的格拉斯哥昏迷评分(GCS)高于预后不良组,发病至开始治疗时间短于预后不良组,差异均有统计学意义(P<0.05)。预后良好组患者T1和T2时间点miR-3195、T2时间点miR-328-5p、T1和T2时间点miR-6867-5p相对表达量均低于同期预后不良组(P<0.05)。2组患者T2时间点miR-3195、miR-328-5p和miR-6867-5p的相对表达量均低于T1时间点(P<0.05)。预后良好组的miR-6867-5p相对表达量降低程度高于预后不良组(P<0.05)。T2时间点miR-3195、miR-328-5p和miR-6867-5p的ROC曲线下面积(AUC)大于T1时间点,差异均有统计学意义(P<0.05)。高GCS是创伤性脑损伤预后的独立保护因素(P<0.05),发病至开始治疗时间过长、T2时间点患者miR-3195和miR-6867-5p高表达是创伤性脑损伤预后的独立危险因素(P<0.05)。结论创伤性脑损伤患者高压氧治疗后血清miR-3195和miR-6867-5p水平与预后密切相关,而miR-328-5p水平与预后无关。

Objective To explore the changes in miR-3195,miR-328-5p,and miR-6867-5p expressions levels and their relationships with the prognosis of patients with traumatic brain injury after hyperbaric oxygen(HBO)therapy.Methods A total of 124 patients with traumatic brain injury admitted to the First Hospital of Shanxi Medical University from May 2018 to August 2020 were selected as research subjects.According to the scores of Glasgow Outcome Scale(GOS)six months after onset,patients with traumatic brain injury were divided into good prognosis group(n=75)and poor prognosis group(n=49).The expression levels of MiR-3195,miR-328-5p,and miR-6867-5p before HBO treatment(T1)and after one month of HBO treatment(T2)were detected by real-time fluorescence quantitative PCR.Receiver operating characteristics(ROC)curve and Logistic regression were used to assess the efficiencies of these three indicators in evaluating the prognosis of patients given HBO therapy for traumatic brain injury and their relationships with prognosis.Results The Glasgow coma scale(GCS)scores of the good prognosis group were higher than those of the poor prognosis group,and the time from onset to treatment was shorter than that of the poor prognosis group,the differences were statistically significant(P<0.05).The relative expression levels of miR-3195 at T1 and T2,miR-328-5p at T2,and miR-6867-5p at T1 and T2 in the good prognosis group were lower than those in the poor prognosis group(P<0.05).The relative expression levels of miR-3195,miR-328-5p,and miR-6867-5p at T2 were all lower than those at T1 in both groups(P<0.05).The relative expression levels of miR-6867-5p in both groups were all reduced,yet the reduction in the good prognosis group was greater than that in the poor prognosis group(P<0.05).The areas under the curve(AUC)of miR-3195,miR-328-5p,and miR-6867-5p at T2 were bigger than those at T1,and the differences were all statistically significant(P<0.05).GCS was an independent protective factor for the prognosis of traumatic brain injury(P<0.05),while the time from onset to treatment and the expression levels of miR-3195 and miR-6867-5p at T2 were independent risk factors for the prognosis of traumatic brain injury(P<0.05).Conclusion The expression levels of miR-3195 and miR-6867-5p are highly related to the prognosis of patients with traumatic brain injury after HBO treatment,while the expression level of miR-328-5p is not related to the prognosis.