颅脑损伤患者血清miR-34a、miR-16和纤维蛋白原水平与病情、预后的相关性

Correlation of the serum levels of microRNA-34a, microRNA-16, and fibrinogen with disease severity and prognosis in patients with craniocerebral injury

摘要:

目的 研究血清微小RNA（miR）-34a、miR-16及纤维蛋白原（FIB）与颅脑损伤程度、预后转归的相关性。方法 选取2018年7月—2020年7月运城市中心医院收治的97例颅脑损伤患者为研究组，同期该院体检健康者50例为对照组，对比两组血清miR-34a、miR-16相对表达水平及FIB值，对比不同病情、不同预后患者与其血清miR-34a、miR-16相对表达水平和FIB值的相关性，采用受试者工作特征（ROC）曲线分析血清miR-34a、miR-16相对表达水平及FIB值对颅脑损伤预后评估的价值。结果 研究组血清miR-34a、miR-16相对表达水平高于对照组（P＜0.05），研究组血清FIB值低于对照组（P＜0.05）；重度组血清miR-34a、miR-16相对表达水平较轻中度组升高（P＜0.05），重度组血清FIB值较轻中度组降低（P＜0.05）；预后不良组血清miR-34a、miR-16相对表达水平高于预后良好组（P＜0.05），预后不良组血清FIB值低于预后良好组（P＜0.05）；血清miR-34a、miR-16相对表达水平与颅脑损伤病情及预后均呈正相关（P＜0.05）；血清FIB值与颅脑损伤病情及预后均呈负相关（P＜0.05）；ROC曲线显示，血清miR-34a、miR-16及FIB联合评估颅脑损伤预后的AUC是0.948（95%CI：0.908~0.988），灵敏度是83.31，特异度是96.02。结论 血清miR-34a、miR-16及FIB水平与颅脑损伤病情程度、预后转归关系密切，3项指标水平联合检测对颅脑损伤患者预后有较高的评估价值。

Abstract:

Objective To investigate the correlation of the serum levels of microRNA-34a （miR-34a）， microRNA-16 （miR-16）， and fibrinogen （FIB） with the severity and prognosis of craniocerebral injury.Methods A total of 97 patients with craniocerebral injury who were admitted to our hospital from July 2018 to July 2020 were enrolled as study group， and 50 individuals who underwent physical examination in our hospital during the same period of time were enrolled as control group. The serum levels of miR-34a， miR-16， and FIB were compared between the two groups， and the correlation of the serum levels of miR-34a， miR-16， and FIB with severity and prognosis was compared between patients with different severities and prognoses. The receiver operating characteristic （ROC） curve was used to analyze the value of the serum levels of miR-34a， miR-16， and FIB in predicting the prognosis of craniocerebral injury.Results Compared with the control group， the study group had significantly higher serum levels of miR-34a and miR-16 （P <0.05） and a significantly lower serum level of FIB （P <0.05）. Compared with the mild-to-moderate group， the severe group had significant increases in the serum levels of miR-34a and miR-16 （P <0.05） and a significant reduction in the serum level of FIB （P <0.05）. Compared with the good prognosis group， the poor prognosis group had significantly higher serum levels of miR-34a and miR-16 （P <0.05） and a significantly lower serum level of FIB （P <0.05）. The serum levels of miR-34a and miR-16 were positively correlated with the severity and prognosis of craniocerebral injury （P <0.05）， and the serum level of FIB was negatively correlated with the severity and prognosis of craniocerebral injury （P <0.05）. The ROC curve analysis showed that the serum levels of miR-34a， miR-16， and FIB in combination had an area under the ROC curve of 0.948 （95% confidence interval： 0.908-0.988） in evaluating the prognosis of craniocerebral injury， with a sensitivity of 83.31 and a specificity of 96.02.Conclusions The serum levels of miR-34a， miR-16， and FIB are closely associated with the severity and prognosis of craniocerebral injury， and the combined measurement of the levels of the three indicators has a high value in evaluating the prognosis of patients with craniocerebral injury.