显微手术对脑神经胶质瘤术后康复进程、神经功能及血清miR-720、miR-375水平的影响

The effect of microsurgery on postoperative rehabilitation process,neurological function and serum miR-720 and miR-375 levels of brain glioma

目的:研究显微手术对脑神经胶质瘤(Brain glioma,BG)术后康复进程、神经功能及血清微小RNA-720(MicroRNA-720,miR-720)、miR-375水平的影响。方法:选取2017年1月~2019年2月我院收治的105例BG患者,按治疗术式不同分为显微组(n=53)和传统组(n=52)。显微组采用显微手术治疗,传统组采用传统开颅手术治疗。比较两组手术有关指标、临床疗效、并发症及术前、术后6个月、12个月改良长谷川痴呆量表(Revised Hasegawa Dementia Scale,HDS-R)、简易智力状态检查量表(Simple mental state examination scale,MMSE)、Barthel指数(Barthel index,BI)、神经肽指标、血清miR-720、miR-375水平。结果:显微组手术时间、切口长度、术后下床时间、住院时间均较传统组短,术中出血量较传统组低(P<0.05);显微组总有效率较传统组高(P<0.05);显微组术后6个月、12个月HDS-R、MMSE、BI评分高于传统组(P<0.05);显微组术后6个月、12个月脑脊液β-内啡肽(β-Endorphins,β-EP)、催产素(Oxytocin,OT)、精氨酸升压素(Arginine vasopressin,AVP)水平均高于传统组(P<0.05);显微组术后6个月、12个月血清miR-720水平低于传统组,miR-375水平高于传统组(P<0.05);显微组并发症发生率较传统组低(P<0.05)。结论:显微手术治疗BG疗效确切、安全性,具有创伤小、手术时间短、术后康复快等特点,可调节患者血清miR-720、miR-375表达,促进脑脊液神经肽水平恢复,改善认知功能及日常生活能力。

Objective:To study the effect of microsurgery on the postoperative recovery process,neurological function and serum levels of microRNA-720(MicroRNA-720,miR-720)and miR-375 in brain glioma(BG).Methods:A total of 105 patients with BG admitted to our hospital from January 2017 to February 2019 were selected and divided into microscopic group(n=53)and traditional group(n=52)according to different treatment methods.The microscopic group was treated with microsurgery,and the traditional group was treated with traditional craniotomy.The operation-related indicators,clinical efficacy,complications,preoperative,6-month,and 12-month Revised Hasegawa Dementia Scale(HDS-R),Simple mental state examination scale(MMSE),Barthel index(BI),and neuropeptide indexes,serum miR-720 and miR-375 levels were compared between the two groups.Results:The operation time,incision length,postoperative out-of-bed time,and hospital stay in the microscopic group were shorter than those in the traditional group,and the intraoperative blood loss was lower than that in the traditional group(P<0.05);The total effective rate in the microscopic group was higher than that in the traditional group(P<0.05);The HDS-R,MMSE,BI scores of the microscopic group were higher than those of the traditional group at 6 and 12 months after operation(P<0.05);The cerebrospinal fluid levels ofβ-endorphin(β-EP),oxytocin(OT)and arginine vasopressin(AVP)were higher than those in the traditional group(P<0.05);The serum miR-720 level in the microscopic group was lower than that in the traditional group at 6 months and 12 months after operation,and the level of miR-375 was higher than that in the traditional group(P<0.05);The incidence of complications in the microscopic group was lower than that in the traditional group(P<0.05).Conclusion:Microsurgery is effective and safe in the treatment of BG with less trauma,shorter operation time,and quicker postoperative recovery.It can regulate the expression of serum miR-720 and miR-375 in patients,promoting the recovery of cerebrospinal fluid neuropeptide levels,improvement of cognitive function and activities of daily living.