血清外泌体微小RNA-21与微小RNA-124水平变化在一氧化碳中毒并发迟发性脑病中的临床意义  

Clinical significance of changes in serum exosome microRNA-21 and microRNA-124 levels in delayed encephalopathy complicated by carbon monoxide poisoning

作　　者：景少巍 朱浩轩 杨晓燕[1] 骆图南 欧阳晓春 Jing Shaowei;Zhu Haoxuan;Yang Xiaoyan;Luo Tunan;Ouyang Xiaochun(908th Hospital of PLA Joint Service Support Force,Nanchang,Jiangxi 330000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院,江西南昌330000

出　　处：《感染．炎症．修复》2022年第1期13-18,共6页Infection Inflammation Repair

基　　金：江西省卫生和计划生育委员会科技计划(20175567);江西省卫生健康委科技计划(202211376)。

摘　　要：目的:探讨一氧化碳(CO)中毒并发迟发性脑病患者血清外泌体中微小RNA(miR)-21与miR-124的表达变化及其意义。方法:解放军联勤保障部队第九〇八医院2020年7月—2021年10月收治的CO中毒迟发性脑病患者60例作为病例组,以同期体检的健康志愿者35例为对照组,比较病例组与对照组、患者中预后良好组和预后不良组血清外泌体miR-21与miR-124的相对表达量及血清缺氧诱导因子-1α(HIF-1α)、白细胞介素(IL)-6、IL-8水平,并比较不同昏迷程度患者和中毒后不同时间接受高压氧治疗患者的miR-21与miR-124的相对表达量。经多元Logistic回归模型分析患者各指标与预后的关系,并绘制受试者工作特征(ROC)曲线评价本次构建的多元Logistic回归模型评估预后的价值。结果:病例组治疗后血清外泌体miR-21和miR-124表达有所升高,但治疗前后均低于对照组(P<0.001);血清HIF-1α、IL-6、IL-8水平治疗后降低,但治疗前后均高于对照组(P<0.001)。预后良好组治疗后血清外泌体miR-21和miR-124表达高于治疗前与预后不良组,血清HIF-1α、IL-6、IL-8水平低于治疗前与预后不良组(P<0.05),但预后不良组治疗前后上述指标均无明显变化(P>0.05)。Pearson线性相关分析显示患者血清外泌体miR-21、miR-124表达与HIF-1α、IL-6、IL-8水平呈负相关(P<0.05)。根据昏迷程度分组,轻中度昏迷组治疗后血清外泌体miR-21和miR-124表达高于重度昏迷组(P<0.001);根据中毒后接受高压氧疗时间分组,中毒12h内接受高压氧治疗组治疗后上述指标表达高于中毒12h后接受高压氧治疗组(P<0.001)。多元Logistic回归模型分析显示,miR-21和miR-124表达增高及早期行高压氧疗为预后保护因素,而HIF-1α、IL-6、IL-8水平增高及昏迷程度加重为预后危险因素(P<0.01)。结论:CO中毒并迟发性脑病患者的血清外泌体miR-21和miR-124表达下调,二者表达与HIF-1α、IL-6、IL-8水平密切相关,且对预后�Objective:To investigate the expression changes and significance of microRNA(miR-21)and miR-124 in serum exosomes of patients with carbon monoxide(CO)poisoning complicated with delayed encephalopathy.Methods:A total of 60 patients with CO poisoning and delayed encephalopathy admitted to the 908th Hospital of PLA Joint Service Support Force from Jul.2020 to Oct.2021 were selected as the case group.In the same period,35healthy volunteers were selected as the control group.The relative expression levels of miR-21 and miR-124 in serum exosome and the levels of serum hypoxia-inducible factor-1α(HIF-1α),interleukin(IL-6)and IL-8 in patients with good prognosis and poor prognosis were compared between the case group and the control group.The relative expression levels of miR-21 and miR-124 in patients with different degrees of coma and patients receiving hyperbaric oxygen treatment at different times after poisoning were compared.Multivariate Logistic regression model was used to analyze the relationship between indicators and prognosis,and receiver operating characteristic(ROC)curve was drawn to evaluate the prognostic value of multivariate Logistic regression model.Results:The expression of miR-21 and miR-124 in serum exosome in the case group was increased after treatment,but lower than that of the control group before and after treatment(P<0.001).Serum levels of HIF-1α,IL-6 and IL-8 decreased after treatment,but they were higher than those in control group before and after treatment(P<0.001).The expression of miR-21 and miR-124 in serum exosome in the good prognosis group after treatment was higher than that before treatment and in the poor prognosis group.Serum levels of HIF-1α,IL-6 and IL-8 were lower than those before treatment and those with poor prognosis(P<0.05),meanwhile there were no significant changes in the above indexes in the poor prognosis group before and after treatment(P>0.05).Pearson linear correlation analysis showed that the expression of miR-21 and miR-124 in serum exosome were negatively co

关 键 词：微小RNA 一氧化碳中毒 迟发性脑病 缺氧诱导因子-1Α 

分 类 号：R749.63[医药卫生—神经病学与精神病学]