miR-146a联合NLR预测高血压脑出血患者高压氧治疗效果的临床价值  

Clinical value of miR-146a combined with NLR in predicting the efficacy of hyperbaric oxygen therapy in patients with hypertensive cerebral hemorrhage

作　　者：王波 王婵娟[2] 周新管 谢亚荣[1] Wang Bo;Wang Chanjuan;Zhou Xinguan;Xie Yarong(Clinical Laboratory,Yuncheng Central Hospital,Yuncheng 044000,China;Plastic Surgery Department,Yuncheng Central Hospital,Yuncheng 044000,China;Neurosurgery Department,Yuncheng Central Hospital,Yuncheng 044000,China)

机构地区：[1]山西医科大学附属运城市中心医院检验科,运城044000 [2]山西医科大学附属运城市中心医院整形外科,运城044000 [3]山西医科大学附属运城市中心医院神经外二科,运城044000

出　　处：《中华航海医学与高气压医学杂志》2024年第6期728-732,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨微小RNA-146a(miR-146a)联合中性粒细胞与淋巴细胞比值(NLR)预测高血压脑出血患者高压氧治疗效果的临床价值。方法采用目的抽样法选取2020年5月至2022年5月运城市中心医院接收的84例高血压脑出血患者,入院后均行经皮锥颅穿刺血肿引流术,术后予以高压氧辅助治疗。高压氧治疗3个疗程后,采美国国立卫生研究院卒中量表(NIHSS)和斯堪的纳维亚脑卒中量表(SSS)评估患者神经功能恢复情况;使用Sysmex全自动血细胞分析仪检测并计算治疗前后患者全血NLR,采用实时荧光定量PCR法(qRT-PCR)检测治疗前后患者血清miR-146a水平;依据改良Rankin量表(mRS)评估患者高压氧治疗的效果,将患者分为治疗效果良好组56例和治疗效果不佳组28例,分析血清miR-146a水平、NLR与患者不同治疗效果之间的关系,并根据不同治疗效果患者的血清miR-146a水平、NLR绘制受试者工作特征(ROC)曲线,评估二者预测高血压脑出血高压氧治疗效果的临床价值。结果治疗后,患者NIHSS评分、NLR低于治疗前,而miR-146a相对表达量、SSS评分高于治疗前,差异均有统计学意义(P<0.01)。治疗效果良好组患者治疗后miR-146a相对表达量(1.87±0.35)明显高于治疗效果不佳组(1.22±0.16),NLR(1.62±0.37)明显低于治疗效果不佳组(3.74±0.68),差异均有统计学意义(P<0.01);治疗前血清miR-146a水平与NIHSS评分呈负相关(r=-0.422)、与SSS评分呈正相关(r=0.512),NLR与NIHSS评分呈正相关(r=0.436)、与SSS评分呈负相关(r=-0.459),差异均有统计学意义(P<0.01);血清miR-146a水平和NLR预测高血压脑出血患者高压氧治疗效果的最佳截断值分别为1.63、1.78,两者联合预测的ROC曲线下面积为0.81,敏感度和特异度分别为83.56%、68.24%。结论血清miR-146a表达降低、NLR升高与高血压脑出血患者高压氧治疗后患者神经功能恢复及预后密切相关,监测其水平变化对预测高血压脑出血患者高压�Objective To investigate the clinical value of microRNA-146a(miR-146a)combined with neutrophil-to-lymphocyte ratio(NLR)in predicting the efficacy of hyperbaric oxygen therapy in patients with hypertensive intracerebral hemorrhage.Methods A total of 84 patients with hypertensive intracerebral hemorrhage admitted to Yuncheng Central Hospital from May 2020 to May 2022 were selected by convenient sampling method.All of them underwent percutaneous cone-skull puncture hematoma drainage after admission,and were treated with hyperbaric oxygen after surgery.After three courses of hyperbaric oxygen therapy,the recovery of neurological function in patients was assessed using the National Institutes of Health Stroke Scale(NIHSS)and the Scandinavian Stroke Scale(SSS).A Sysmex automated hematology analyzer was used to measure and calculate the patients’whole blood NLR before and after treatment.The serum levels of miR-146a before and after treatment were detected using quantitative real-time PCR(qRT-PCR).Based on the modified Rankin Scale(mRS),the patients were divided into a group with good treatment outcomes(n=56)and a group with poor treatment outcomes(n=28)after hyperbaric oxygen therapy.The relationship between serum miR-146a levels,NLR,and the different treatment outcomes was analyzed.Receiver operating characteristic(ROC)curves were plotted based on serum miR-146a levels and NLR in patients with different treatment outcomes to evaluate their clinical value in predicting the efficacy of hyperbaric oxygen therapy for hypertensive cerebral hemorrhage.Results After treatment,the NIHSS scores and NLR in patients were significantly lower than those before treatment,while the relative expression of miR-146a and SSS scores were significantly higher than those before treatment.These differences were statistically significant(P<0.01).In the good treatment efficacy group,the relative expression level of miR-146a after treatment(1.87±0.35)was higher than that in the poor treatment efficacy group(1.22±0.16),and the NLR level(1.6

关 键 词：高血压脑出血 高压氧治疗 神经功能 预测价值 

分 类 号：R544.1[医药卫生—心血管疾病] R743.34[医药卫生—内科学]