外周血miRNA-124表达水平与创伤性颅脑损伤病情严重程度及预后的关系

Relationship between mirNA-124 expression level in peripheral blood and severity and prognosis of traumatic brain injury

目的探究外周血miRNA-124表达水平与创伤性颅脑损伤病情严重程度及预后的关系方法 选取2019年5月~2022年5月我院诊治的118例创伤性颅脑损伤患者,收集记录患者的一般临床资料以及病情、预后情况,观察外周血miRNA-124表达水平与患者病情严重程度的关系,并采用因素logistic回归分析影响患者预后的独立相关因素,采用受试者工作特性曲线(ROC)评估相关指标预测患者预后的预测价值,并以患者预后对相关指标进行比较分析。结果 118例患者中,轻度27例,中度50例,重度41。轻度组miRNA-124低于中、重度组,中度组miRNA-124低于重度组,差异有统计学意义(P <0.05)。118例患者中,92例预后良好,26例预后不良。影响创伤性颅脑损伤病情严重程度的单因素分析结果提示,D-二聚体、APACHEⅡ评分、国家早期预警评分(NEWS)、miRNA-124、神经元特异性烯醇化酶(NSE)、血糖均是影响创伤性颅脑损伤病情严重程度的相关因素(P <0.05)。进一步多因素logistic回归分析结果提示,miRNA-124(OR=5.436,95%CI:1.600~18.468,P=0.008)、血糖(OR=3.296,95%CI:1.044~10.405,P=0.042)、APACHEⅡ评分(OR=1.633,95%CI:1.023~2.607,P=0.040)均是影响创伤性颅脑损伤病情严重程度的独立危险因素。受试者工作特征曲线(ROC)结果显示,mi RNA-124相对表达量的ROC曲线下面积(AUC)为0.894,其敏感度为0.808,特异度为0.917,3组指标联合的AUC为0.943,其敏感度为0.924,特异度为0.859。结论 患者的miRNA-124、血糖、APACHEⅡ评分均为影响创伤性颅脑损伤病情严重程度的独立影响因素,且miRNA-12相对表达量与3组指标联合对创伤性颅脑损伤病情严重程度具有较好的预测效能,临床治疗可对相关指标予以关注。

Objective To explore the relationship between the expression level of mirNA-124 in peripheral blood and the severity and prognosis of traumatic craniocerebral injury.Methods 118 patients with traumatic craniocerebral injury treated in our hospital from May 2019 to May 2022 were selected as the research objects,and the general clinical data,condition and prognosis of the patients were collected and recorded.The relationship between the expression level of mirNA-124 in peripheral blood and the severity of the disease was observed.Logistic regression was used to analyze the independent related factors affecting the prognosis of patients.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of related indicators in predicting the prognosis of patients.Results Among the 118 patients,27 cases were mild,50 cases were moderate and 41 cases were severe.miRNA-124 in the mild group was lower than that in the moderate and severe groups(P<0.05),and miRNA-124 in the moderate group was lower than that in the severe group(P<0.05).Among the 118 patients,92 had good prognosis and 26 had poor prognosis.The univariate analysis results of influencing the severity of traumatic brain injury suggested that D-dimer,APACHEⅡscore,National Early Warning score(NEWS),miRNA-124,Neuron-specific enolase(NSE)and blood glucose were related factors affecting the severity of traumatic brain injury(P<0.05).Further multiariable Logistic regression analysis results suggest that the miRNA-124(OR=5.436,95%CI:1.600~18.468,P=0.008),blood glucose(OR=3.296,95%CI:1.044~10.405,P=0.042)and APACHEⅡscore(OR=1.633,95%CI:1.023-2.607,P=0.040)were independent risk factors affecting the severity of traumatic brain injury.The ROC results showed that the area under the ROC curve(AUC)of mirNA-124 relative expression was 0.894,its sensitivity was 0.808,and its specificity was 0.917.The AUC of the combination of the three groups of indicators was 0.943,its sensitivity was 0.924,and its specificity was 0.859.Conclusions miRNA-124,blood glucose and APACHEⅡscore are independent influencing factors of severity of traumatic brain injury,and the relative expression of miRNA-124 combined with the three groups of indicators has a good predictive effect on severity of traumatic brain injury,and the relevant indicators can be paid attention to in clinical treatment.