微小RNA-29a及水通道蛋白4与创伤性脑损伤和预后的关系  

Correlation between microRNA-29a and aquaporin4 with traumatic brain injury and prognosis

作　　者：宋婷 杨娟 曹双 张吉东 Song Ting;Yang Juan;Cao Shuang;Zhang Jidong(Center frr Neurological Diseases,the Third Affiliated Hospital of Chongqing Medical University Chongqing 401120,China)

机构地区：[1]重庆医科大学附属第三医院神经疾病中心,401120

出　　处：《中华老年心脑血管病杂志》2023年第7期716-719,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：重庆市自然科学基金(30114-1977)。

摘　　要：目的探究微小RNA-29a(miR-29a)/水通道蛋白(AQP)4在早期急性创伤性脑水肿(TBE)中的表达和术后神经功能损伤及预后的相关性。方法收集2018年1月至2019年6月重庆医科大学附属第三医院神经疾病中心收治的老年重型脑挫伤患者50例,根据术前头颅CT检查结果分为阴性组5例、轻度组11例、中度组20例、重度组14例。检测患者血清及组织miR-29a水平、组织AQP4水平,采用美国国立卫生研究院卒中量表(NIHSS)评估患者术后神经功能损伤情况,格拉斯哥昏迷评分(GCS)评价患者预后情况,GCS4~5分纳入预后良好组11例,GCS<4分纳入预后不良组39例。结果阴性组、轻度组、中度组和重度组组织AQP4蛋白表达量逐渐增加,同时组织和血清miR-29a相对表达量逐渐降低(P<0.01);血清和组织miR-29a相对表达量与组织AQP4蛋白表达量均呈负相关性(r=-0.748、r=-0.538,P<0.01);组织AQP4蛋白表达量与NIHSS评分呈正相关性(r=0.634,P<0.01),而血清和组织miR-29a相对表达量与NIHSS评分呈负相关性(r=-0.700、r=-0.801,P<0.01)。与预后良好组比较,预后不良组组织AQP4蛋白表达量升高,组织、血清miR-29a相对表达量降低(P<0.01)。ROC曲线分析显示,术前血清miR-29a相对表达量预测患者预后不良曲线下面积为0.879(95%CI:0.746~1.000)。结论老年患者早期急性TBE后脑水肿程度越严重,组织中AQP4表达越高,同时组织与血清中miR-29a表达越低,与术后神经功能下降有关。检测血清miR-29a相对表达量可提供一定的预后信息。Objective To investigate the expression of microRNA-29a/aquaporin-4(miR-29a/AQP4)in early acute traumatic brain edema(TBE)tissue and its correlation with postoperative neurological function impairment and prognosis.Methods The clinical data of 50 elderly patients with severe brain contusion admitted to our center from January 2018 to June 2019 were retrospectively collected.According to the preoperative severity of cerebral edema by CT scans,they were divided into negative group(n=5),mild group(n=11),moderate group(n=20)and severe group(n=14).The serum and tissue levels of miR-29a and tissue level of AQP<4 were detected in all the patients.NIHSS was used to assess the postoperative neurological impairment,and GCS scale was used to evaluate the prognosis of patients.Those with GCS score 4~5 were included in the good prognosis group(11 cases),while those with score 4 in the poor prognosis group(39 cases).Results With the aggravation of brain edema,the tissue AQP4 level was increased gradually,while the tissues and serum levels of miR-29a were decreased(P<0.01).The levels of miR-29a in serum and tissues were negatively correlated with the tissue level of AQP4(r=-0.748,-0.538,P<0.01).AQP4 level expression in tissues had a positive correlation with NIHSS score(r=0.634,P<0.01),while serum and tissue levels of miR-29a had negative correlations with the score(r=-0.700,-0.801,P<0.01).Moreover,the poor prognosis group had significantly higher AQP4 level but lower level of miR-29a in tissue and serum when compared with the good prognosis group(P<0.01).The AUC value of preoperative serum miR-29a level in predicting poor prognosis was 0.879 in the patients(95%CI:0.746-1.000).Conclusion The more severe the brain edema after early acute TBE in the elderly patients,the higher the expression level of AQP4 in tissue,and the lower the expression of miR-29a in tissue and serum,which are related to the decline of neurological function after operation.And serum miR-29a can provide a certain reference for prognosis.

关 键 词：脑损伤 脑水肿 循环微RNA 水通道蛋白质4 预后 数据相关性 微小RNA-29a 

分 类 号：R651.15[医药卫生—外科学]