脑动脉瘤破裂出血后血清miR-27a、miR-193b-3p水平与脑血管痉挛的相关性及预测价值  

Correlation and predictive value of serum miR-27a and miR-193b-3p levels with cerebral vasospasm after cerebral aneurysm rupture and hemorrhage

作　　者：马骁[1] 杨世峰[1] 周新管 任登鹏 王磊[1] 李太红 Ma Xiao;Yang Shifeng;Zhou Xinguan;Ren Dengpeng;Wang Lei;Li Taihong(Department of Neurolosurgy,Yuncheng Central Hospital of Shaanxi Medical University,Yuncheng,Shaanxi 044000,China)

机构地区：[1]山西医科大学附属运城市中心医院神经外科,运城044000

出　　处：《脑与神经疾病杂志》2025年第4期206-211,共6页Journal of Brain and Nervous Diseases

基　　金：山西省科学技术研究与开发项目(202201D752032)。

摘　　要：目的探究脑动脉瘤(IA)破裂出血后血清微小RNA-27a(miR-27a)、微小RNA-193b-3p(miR-193b-3p)水平与脑血管痉挛(CVS)的相关性及预测价值。方法选取2022年1月至2024年1月山西医科大学附属运城市中心医院收治的IA破裂出血患者120例,根据入院后是否并发CVS分为CVS组和对照组。比较CVS组和对照组入院时一般资料、血清miR-27a、miR-193b-3p水平,分析IA破裂出血后并发CVS的影响因素,并分析入院时血清miR-27a、miR-193b-3p预测IA破裂出血后并发CVS的价值。结果IA破裂出血后CVS发生率为40.83%(49/120);CVS组入院时年龄、高血压占比、IA大小≥1cm占比、Hunt-Hess分级3~5级占比、Fisher分级Ⅲ~Ⅳ级占比高于对照组,血清miR-27a、miR-193b-3p水平低于对照组(P<0.05);年龄、高血压、IA大小、Hunt-Hess分级、Fisher分级、血清miR-27a、miR-193b-3p水平均为IA破裂出血后并发CVS的影响因素(P<0.05);入院时血清miR-27a、miR-193b-3p预测IA破裂出血后并发CVS的曲线下面积(AUC)分别为0.771、0.828,两者联合预测CVS的AUC为0.937,大于单独预测CVS(P<0.05);入院时血清miR-27a、miR-193b-3p联合在预测IA破裂出血后并发CVS风险方面具有良好临床效果,且预测结果与实际情况具有较高的符合率。结论IA破裂出血后血清miR-27a、miR-193b-3p水平与CVS的发生存在显著关联性,且具有预测CVS的价值,两者联合可为临床早期识别CVS高危患者提供可靠临床依据。Objective To explore the correlation and predictive value of serum microRNA-27a(miR-27a)and microRNA-193b-3p(miR-193b-3p)levels with cerebral vasospasm(CVS)after rupture and hemorrhage of cerebral aneurysm(IA).Methods A total of 120 patients with IA rupture and bleeding admitted to the Yuncheng Central Hospital affiliated to Shaanxi Medical University from January 2022 to January 2024 were selected and divided into a CVS group and a control group based on whether they had CVS after admission.The general data,serum levels of miR-27a and miR-193b-3p at admission,and the impact factors of CVS after IA rupture and bleeding were compared between the CVS group and the control group.The value of serum levels of miR-27a and miR-193b-3p at admission in predicting CVS after IA rupture and bleeding was analyzed.Results The incidence of CVS after IA rupture and bleeding was 40.83%(49/120);The age,proportion of hypertension,proportion of IA size≥1 cm,proportion of Hunt-Hess grade 3-5,and proportion of Fisher gradeⅡ-Ⅳat admission in the CVS group were higher than those in the control group,and the levels of serum miR-27a and miR-193b-3p were lower than those in the control group(P<0.05).Age,hypertension,IA size,Hunt-Hess classification,Fisher classification,serum miR-27a,and miR-193b-3p levels were all factors that affected the occurrence of CVS after IA rupture and bleeding(P<0.05).The area under the curve(AUC)of serum miR-27a and miR-193b-3p for predicting CVS after IA rupture and bleeding was 0.771 and 0.828,respectively,when they were admitted to the hospital.The AUC of the combination of the two for predicting CVS was 0.937,which was greater than that of the single prediction of CVS(P<0.05).The combined use of serum miR-27a and miR-193b-3p at admission has good clinical utility in predicting the risk of CVS after IA rupture and bleeding,and the prediction results have a high concordance rate with the actual situation.Conclusion The levels of serum miR-27a and miR-193b-3p after IA rupture and bleeding are significant

关 键 词：脑动脉瘤 破裂出血 脑血管痉挛 微小RNA-27a 微小RNA-193b-3p 

分 类 号：R743.34[医药卫生—神经病学与精神病学]