急性脊髓损伤患者外周血miR-124-3p、miR-145-5p水平及意义

Levels and significance of peripheral blood miR-124-3p and miR-145-5p in patients with acute spinal cord injury

目的探讨急性脊髓损伤(SCI)患者外周血微小RNA-124-3p(miR-124-3p)和微小RNA-145-5p(miR-145-5p)的水平及意义。方法选择2018年1月至2023年1月该院收治的112例急性SCI患者作为SCI组,选择同期在该院体检的102例体检健康受试者作为对照组。根据美国脊髓损伤学会评分(ASIA)分级,将SCI患者分为脊髓不完全损伤组(78例)和脊髓完全损伤组(34例),根据预后情况将患者分为预后良好组和预后不良组。采用实时荧光定量PCR(qRT-PCR)检测所有研究对象外周血miR-124-3p和miR-145-5p水平;通过受试者工作特征(ROC)曲线分析miR-124-3p、miR-145-5p水平对SCI患者预后不良的预测价值;采用多因素Logistic回归分析影响SCI患者预后不良的因素。结果与对照组相比,SCI组miR-124-3p水平降低、miR-145-5p水平升高,差异均有统计学意义(P<0.05)。与脊髓不完全损伤组相比,脊髓完全损伤组miR-124-3p水平降低,miR-145-5p水平升高,差异均有统计学意义(P<0.05)。与预后良好组相比,预后不良组miR-124-3p水平降低、miR-145-5p水平升高,差异均有统计学意义(P<0.05)。miR-124-3p、miR-145-5p联合检测预测SCI患者预后不良的曲线下面积(AUC)优于miR-124-3p、miR-145-5p单项预测的AUC(Z=2.143,P=0.032;Z=2.952,P=0.003)。miR-145-5p水平升高是SCI患者预后不良的独立危险因素(P<0.05),miR-124-3p水平升高是SCI患者预后不良的保护因素(P<0.05)。结论SCI患者外周血miR-124-3p水平降低、miR-145-5p水平升高,其变化与脊髓损伤程度有关,且对患者预后有一定的预测价值。

Objective To explore the levels and significance of peripheral blood microRNA-124-3p(miR-124-3p)and microRNA-145-5p(miR-145-5p)in the patients with acute spinal cord injury(SCI).Methods A total of 112 patients with acute SCI admitted and treated in this hospital from January 2018 to January 2023 were selected as the SCI group,and 102 healthy subjects undergoing physical examination in this hospital during the same period were selected as the control group.According to the American Academy of Spinal Cord Injury(ASIA)grading,the SCI patients were divided into the spinal cord incomplete injury group(78 cases)and spinal cord complete injury group(34 cases).The patients were divided into the good prognosis group and poor prognosis group based on their prognosis.The real time fluorescence quantitative PCR(qRT-PCR)was used to detect the peripheral blood iR-124-3p and miR-145-5p levels in all study subjects;the predictive value of miR-124-3p and miR-145-5p levels for poor prognosis in SCI patients was analyzed through receiver operating characteristic(ROC)curve;the multivariate Logistic regression was adopted to analyze the factors affecting the poor prognosis of SCI patients.Results Compared with the control group,the miR-124-3p level in the SCI group was decreased,miR-145-5p level was increased,and the differences were statistically significant(P<0.05).Compared with the spinal cord incomplete injury group,the miR-124-3p level in the spinal cord complete injury group was decreased,the miR-145-5p level was increased,and the differences were statistically significant(P<0.05).Compared with the good prognosis group,the miR-124-3p level in the poor prognosis group was decreased and miR-145-5p level was increased,and the differences were statistically significant(P<0.05).The area under the curve(AUC)of the miR-124-3p and miR-145-5p combined detection for predicting poor prognosis in SCI patients was better than AUC of miR-124-3p and miR-145-5p single prediction(Z=2.143,P=0.032;Z=2.952,P=0.003).The increase of miR-145-5p level was an independent risk factor for poor prognosis in SCI patients(P<0.05),while the increase of miR-124-3p level was a protective factor for poor prognosis in SCI patients(P<0.05).Conclusion The peripheral blood miR-124-3p level in SCI patients is decreasd and miR-145-5p level is increased,their change is related to the degree of spinal cord injury,moreover which has a certain predictive value for prognosis in the patients.