颅脑损伤患儿血清中miR-34a和NO TNF-α表达及意义  

Expressions and Significance of Serum MiR-34a NO and TNF-α in Children with Craniocerebral Injury

作　　者：汪生毅 孙小红 王新法[2] WANG Shengyi;SUN Xiaohong(Qinghai Women and Children's Hospital,Qinghai Xining 810003,China)

机构地区：[1]青海省妇女儿童医院脑外科,青海西宁810000 [2]江苏省南京市儿童医院神经外科,江苏南京210000

出　　处：《河北医学》2020年第12期1947-1951,共5页Hebei Medicine

基　　金：青海省卫生计生课题指导性计划项目,(编号:2017-wjzdx-29)。

摘　　要：目的:研究颅脑损伤患儿血清中微小RNA-34a(miR-34a)和一氧化氮(NO)、肿瘤坏死因子-α(TNF-α)表达水平及意义。方法:选取2017年9月至2019年8月青海省妇女儿童医院收治的78例颅脑损伤患儿为颅脑损伤组,根据格拉斯哥昏迷(GCS)评分将其分为轻度组23例,中度组30例,重度组25例;同时选取同期体检健康的儿童80例为对照组。采用实时荧光定量PCR(qRT-PCR)法检测血清中miR-34a水平;采用化学比色法检测血清中NO水平;采用酶联免疫吸附(ELISA)法检测血清中TNF-α水平。Pearson法分析血清miR-34a、NO、TNF-α与GCS评分相关性。受试者工作特征曲线(ROC)分析血清miR-34a、NO、TNF-α水平对TBI的预测价值。结果:①颅脑损伤组患儿血清中miR-34a、NO、TNF-α水平均高于对照组,差异有统计学意义(P<0.05);②重度组颅脑损伤患儿血清中miR-34a、NO、TNF-α水平均高于中度组与轻度组,中度组颅脑损伤患儿血清中miR-34a、NO、TNF-α水平均高于轻度组,差异有统计学意义(P<0.05);③经Pearson法分析得,颅脑损伤患儿血清miR-34a、NO、TNF-α水平与GCS评分均呈负相关,差异有统计学意义(P<0.05);④血清miR-34a、NO、TNF-α水平预测TBI的曲线下面积分别为0.821(95%CI:0.675~0.967)、0.902(95%CI:0.816~0.989)、0.851(95%CI:0.741~0.961),截断值为0.65、38.45μmoL/L、153.49pg/mL,敏感度为88.9%、94.4%、72.2%,特异度72.0%、70.0%、98.0%;联合检测预测TBI的曲线下面积为0.998(95%CI:0.992~1.000),敏感度为100.0%,特异度98.0%;⑤死亡组患儿血清中miR-34a、NO、TNF-α水平明显高于存活组,差异有统计学意义(P<0.05)。结论:miR-34a、NO、TNF-α在颅脑损伤患儿血清中均呈高表达水平,与颅脑损伤程度密切相关,联合检测具有一定预测价值,对颅脑损伤患儿不良预后的评估有一定参考意义。Objective:To study the expression levels of microRNA-34a(miR-34a),nitric oxide(NO)and tumor necrosis factor-α (TNF-α)in serum of children with craniocerebral injury and their significance.Methods:78 children with craniocerebral injury admitted to Qinghai Women and Children's Hospital from September 2017 to August 2019 were divided into mild group(23 cases),moderate group(30 cases)and severe group(25 cases)according to Glasgow Coma score(GCS);at the same time,80 healthy controls in the same period were selected.Real-time quantitative PCR(qRT-PCR)was used to detect the level of miR-34a in serum;the level of NO in serum was detected by chemical colorimetry;and enzyme-linked immunosorbent assay(ELISA)was used to detect the level of TNF-α in serum.Pearson method was used to analyze the correlation between serum miR-34a,NO,TNF-α and GCS score.Receiver operating characteristic curve(ROC)was applied to analyze the predictive value of serum miR-34a,NO,TNF-α levels for TBI.Results:①The levels of serum miR-34a,NO and TNF-α in children with craniocerebral injury were higher than those in the control group,and the differences were significant(P<0.05);②The levels of serum miR-34a,NO and TNF-α in severe group were higher than those in moderate group and mild group,the levels of serum miR-34a,NO and TNF-α in moderate group were higher than those in mild group,and the differences were significant(P<0.05);③Pearson analysis showed that levels of serum miR-34a,NO and TNF-α were negatively correlated with GCS scores in children with craniocerebral injury(P<0.05);④The area under the curve of TBI predicted by serum miR-34a,NO and TNF-α levels is 0.821(95%CI:0.675~0.967),0.902(95%CI:0.816~0.989),0.851(95%CI:0.741~0.961);cutoff values are 0.65,38.45μmol/L,153.49 pg/mL;sensitivity is 88.9%,94.4%,72.2%;specificity is 72.0%,70.0%,98.0%;The area under the curve predicted by the joint detection is 0.998(95%CI:0.992~1.000);the sensitivity is 100.0%;and the specificity is 98.0%;⑤The levels of serum miR-34a,NO and TNF-α in

关 键 词：颅脑损伤 微小RNA-34a 一氧化氮 肿瘤坏死因子-Α 

分 类 号：R726.5[医药卫生—儿科]