动脉瘤性蛛网膜下腔出血患者高压氧治疗后血清miR-193b-3p水平及其意义

The level and significance of miR-193b-3p in patients with aneurysmal subarachnoid hemorrhage after hyperbaric oxygen treatment

目的探讨动脉瘤性蛛网膜下腔出血(aSAH)患者高压氧治疗后血清miR-193b-3p水平的变化及其意义。方法选择2019年1月至2020年9月商丘市第一人民医院急诊科收治的176例aSAH患者作为研究对象,根据治疗90 d后患者的改良Rankin量表评分(mRS)将其分为预后良好组(n=128)和预后不良组(n=48)。采用实时荧光定量PCR法检测血清miR-193b-3p相对表达水平;用Logistic回归分析aSAH患者预后的风险因素;用受试者工作特征(ROC)曲线评价miR-193b-3p诊断aSAH患者预后的价值;用限制性立方样条拟合Logistic回归分析miR-193b-3p与aSAH患者预后的量效关系。结果预后良好组患者治疗前后血清miR-193b-3p的相对表达水平均高于同期预后不良组(P<0.05),治疗后2组患者血清miR-193b-3p的相对表达水平均明显降低(P<0.05)。治疗后miR-193b-3p诊断aSAH预后的ROC曲线下面积(AUC)、灵敏度和特异度分别为0.818、68.75%和85.94%。Hunt-HessⅢ~Ⅳ级、脑血管痉挛、高格拉斯哥昏迷评分(GCS)和高C反应蛋白(CRP)水平是aSAH预后的独立危险因素(P<0.05),治疗后miR-193b-3p相对表达水平高是aSAH预后的独立保护因素(P<0.05)。治疗后miR-193b-3p与aSAH预后呈非线性关系(P<0.05)。结论aSAH患者高压氧治疗后血清miR-193b-3p相对表达水平明显降低,与aSAH预后不良有关。

Objective To investigate the changes in the level of microRNA-193b-3p(miR-193b-3p)in patients with aneurysmal subarachnoid hemorrhage(aSAH)after hyperbaric oxygen(HBO)treatment and to explore its significance.Methods A total of 176 patients with aSAH admitted to the Emergency Department of the First People’s Hospital of Shangqiu from January 2019 to September 2020 were selected as the research subjects.They were divided into sound prognosis group(n=128)and poor prognosis group(n=48)according to scores of the modified Rankin Scale(mRS)90 days after treatment.The relative expression levels of miR-193b-3p were detected by real-time quantitative PCR(RT-qPCR).The prognostic risk factors of aSAH patients were analyzed by logistic regression.The value of miR-193b-3p in judging the prognosis of aSAH patients was evaluated by receiver operating characteristic(ROC)curve.The dose-response relationship between miR-193b-3p and prognosis in aSAH patients was analyzed by the logistic regression using restricted cubic splines.Results The relative expression levels of miR-193b-3p in the sound prognosis group before and after treatment were higher than those in the poor prognosis group at the same time points(P<0.05),and the relative expression levels of miR-193b-3p in both groups were decreased after treatment(P<0.05).The area under the ROC curve(AUC),sensitivity,and specificity of post-treatment miR-193b-3p in judging the prognosis of aSAH patients were 0.818,68.75%,and 85.94%,respectively.Hunt-HessⅢ-Ⅳ,cerebral vasospasm(CVS),Glasgow Coma scale(GCS)rating,and high C-reactive protein(CRP)level were independent risk factors for aSAH prognosis(P<0.05);the relatively high expression level of post-treatment miR-193b-3p was an independent protective factor for aSAH prognosis(P<0.05).Post-treatment miR-193b-3p had a non-linear relationship with the prognosis of aSAH(P<0.05).Conclusion After HBO treatment,the relative expression level of miR-193b-3p in aSAH patients was decreased,which is related to the poor prognosis of aSAH.