HIF-1α、miRNA-21表达与脑挫伤患者预后的相关性研究  

Correlation among the expression of HIF-1α and miRNA-21 with prognosis in patients with brain contusion

作　　者：包强吉 陈淑君 李一鸣 曹大海 杨明飞[3] Bao Qiangji;Chen Shujun;Li Yiming;Cao Dahai;Yang Mingfei(Neurosurgery Department,Guang'an People's Hospital,Guang'an 638500,China;Graduate School,Qinghai University,Xining 810016,China;Neurosurgery Department,Qinghai Provincial People's Hospital,Xining 810007,China)

机构地区：[1]广安市人民医院神经外科,638500 [2]青海大学研究生院,西宁810016 [3]青海省人民医院神经外科,西宁810007

出　　处：《神经疾病与精神卫生》2023年第10期697-703,共7页Journal of Neuroscience and Mental Health

基　　金：青海省卫生健康系统重点课题(2021-wjzd-01)。

摘　　要：目的 探讨脑挫伤患者伤后24 h内缺氧诱导因子-1α(HIF-1α)、miRNA-21水平变化与患者预后的关系。方法 选取2021年3月至2022年11月在青海省人民医院神经外科住院治疗的30例脑挫伤患者为脑挫伤组,同期选取在我院体检中心体检的15名健康人群为健康对照组。分别采用酶联免疫吸附试验和逆转录-聚合酶链式反应检测两组血清HIF-1α和miRNA-21水平。患者的创伤严重程度采用格拉斯哥昏迷评分(GCS)评估,并根据入院后7 d GCS评分变化将患者分为GCS评分减少组(n=14)和增加组(n=16)。患者伤后30 d格拉斯哥预后评分(GOS)1~3分定义为预后不良。采用Spearman相关分析脑挫伤患者GCS评分与HIF-1α、miRNA-21之间的关系,通过多因素Logistic回归分析患者预后不良的影响因素,采用受试者工作特征(ROC)曲线评估miRNA-21和HIF-1α对脑挫伤患者预后不良的诊断价值。结果 脑挫伤组的血清HIF-1α、miRNA-21水平高于健康对照组,差异有统计学意义(t=-5.991、-6.722;P<0.05)。患者血清HIF-1α、miRNA-21水平与GCS评分、GOS评分呈负相关(r=-0.74、-0.54、-0.51、-0.62;P<0.001),血清HIF-1α、miRNA-21水平呈正相关(r=0.50,P<0.001)。入院后7 d,GCS评分增加组的HIF-1α水平低于GCS评分减少组,差异有统计学意义(P<0.05);两组的miRNA-21水平比较,差异无统计学意义(P>0.05)。血清HIF-1α水平为305.00 pg/ml、miRNA-21水平为3.95,区分30 d预后不良患者的特异度和敏感度分别为90.5%和66.7%、95.2%和66.7%。结论 血清HIF-1α和miRNA-21有助于脑挫伤的预后预测。Objective To explore the changes of hypoxia inducible factor-1α(HIF-1α) and miRNA-21 levels in brain contusion patients within 24 hours after injury and their correlation with prognosis.Methods Thirty patients with brain contusion in the Neurosurgery Department of Qinghai Provincial People's Hospital from March 2021 to November 2022 were in the brain contusion group, while 15 healthy individuals who underwent physical examination in Physical Examination Center were included in the control group during the same period. Two groups of serum HIF-1α and miRNA-21 levels were detected using enzymelinked immunosorbent assay and reverse transcription polymerase chain reaction, respectively. The severity of the patient's trauma was evaluated using the Glasgow Coma Scale(GCS), and the patient was divided into a decreased GCS score group(n=14) and an increased GCS score group(n=16) based on changes in the GCS score 7 days after admission. The Glasgow Outcome Scale(GOS) score of 1 to 3 points 30 days after injury was defined as poor prognosis. Spearman correlation was used to analyze the relationship between GCS score and HIF-1αand miRNA-21 in patients with brain contusion, and the influencing factors of poor prognosis were analyzed through multivariate Logistic regression. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of miRNA-21 and HIF-1α for poor prognosis in patients with brain contusion. Results The serum levels of HIF-1α and miRNA-21 in the brain contusion group were higher than those in the control group, with statistical differences(t=-5.991,-6.722;P<0.05). The serum levels of HIF-1α and miRNA-21 were negatively correlated with GCS score and GOS score(r=-0.74,-0.54,-0.51,-0.62;P<0.001), while the serum levels of HIF-1α and miRNA-21 were positively correlated(r=0.50, P<0.001), and the differences were all statistically significant. On the seventh day after admission, the HIF-1α level in the increased GCS score group was lower than that in the decreased GCS score group,

关 键 词：脑挫伤 缺氧诱导因子 微小核糖核酸-21 严重程度 预后 

分 类 号：R651.15[医药卫生—外科学]