血清微小RNA-20a-5p、微小RNA-128-3p与缺氧缺血性脑病患儿脑神经发育的关系

Relationships of serum microRNA-20a-5p and microRNA-128-3p with cranial nerve development in children with hypoxic-ischemic encephalopathy

目的分析微小RNA(miR)-20a-5p、miR-128-3p在缺氧缺血性脑病(HIE)早产儿血清中的表达与脑神经发育的关系。方法选取95例HIE早产儿为HIE组,根据HIE早产儿病情严重程度,将其分为轻度组(n=27)、中度组(n=46)、重度组(n=22);另选取同期95例无HIE早产儿为对照组。评估2组早产儿Apgar评分和新生儿神经行为测定评分法(NBNA)评分;采用实时荧光定量聚合酶链式反应(qRT-PCR)检测血清中miR-20a-5p和miR-128-3p表达水平;Spearman法分析血清miR-20a-5p、miR-128-3p水平与Apgar评分、NBNA评分的相关性;受试者工作特征(ROC)曲线分析血清miR-20a-5p、miR-128-3p水平对早产儿发生HIE的诊断价值。结果与对照组相比,HIE组血清miR-20a-5p、miR-128-3p水平升高,Apgar评分、NBNA评分降低,差异有统计学意义(P<0.05)。轻度组、中度组、重度组血清miR-20a-5p、miR-128-3p水平依次升高,Apgar评分、NBNA评分依次降低,差异均有统计学意义(P<0.05)。Spearman法分析结果显示,血清miR-20a-5p水平与Apgar评分、NBNA评分呈负相关(r=-0.659、-0.548,P均<0.001),血清miR-128-3p水平与Apgar评分、NBNA评分呈负相关(r=-0.582、-0.499,P均<0.001)。血清miR-20a-5p、miR-128-3p联合预测早产儿发生HIE的曲线下面积(AUC)为0.920,敏感度为78.95%,特异度为97.89%。二者联合对早产儿发生HIE的预测效能优于miR-20a-5p、miR-128-3p单独预测,差异有统计学意义(P<0.05)。结论HIE早产儿血清miR-20a-5p、miR-128-3p水平升高,且与病情严重程度和脑神经发育密切相关。miR-20a-5p、miR-128-3p联合检测对早产儿HIE发生有较好的预测价值。

Objective To analyze the relationships of expressions of serum microRNA(miR)-20a-5p and miR-128-3p with cranial nerve development in the premature infants with hypoxic-ischemic encephalopathy(HIE).Methods A total of 95 HIE premature infants were selected as HIE group,and according to the severity of HIE,they were divided into mild group(n=27),moderate group(n=46)and severe group(n=22);another 95 premature infants without HIE in the same period were selected as control group.Apgar score and the Neonatal Behavioral Neurological Assessment(NBNA)score were performed in both groups;the expression levels of miR-20a-5p and miR-128-3p in serum were detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR);Spearman method was used to analyze the correlations of serum miR-20a-5p and miR-128-3p levels with Apgar score and NBNA score;the values of serum miR-20a-5p and miR-128-3p levels in diagnosing HIE in premature infants were analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the levels of serum miR-20a-5p and miR-128-3p in the HIE group increased significantly,while the Apgar score and NBNA score decreased significantly(P<0.05).In the mild,moderate,and severe groups,the levels of serum miR-20a-5p and miR-128-3p increased gradually,while the Apgar score and NBNA score decreased gradually,with the significant between-group differences Spearman analysis results showed that the level of serum miR-20a-5p was negatively correlated with the Apgar score and NBNA score(r=-0.659,-0.548,P<0.001),and the level of serum miR-128-3p was negatively correlated with the Apgar score and NBNA score(r=-0.582,-0.499,P<0.001).The combined prediction of serum miR-20a-5p and miR-128-3p for HIE in premature infants had an area under the curve(AUC)of 0.920,with a sensitivity of 78.95%and a specificity of 97.89%.The predictive efficacy of the combined model was superior to that of miR-20a-5p and miR-128-3p alone(P<0.05).Conclusion The serum levels of miR-20a-5p and miR-128-3p increase in the premature infants with HIE,and are closely related to the severity of the disease and the development of brain nerves.The combined detection of miR-20a-5p and miR-128-3p has good predictive value for the occurrence of HIE in premature infants.