摘要
目的:研究高血压脑出血患者血肿周围脑组织miR-146a表达与自噬及短期预后的关系。方法:在我院接受血肿清除术并完成术后3个月随访的高血压脑出血患者204例纳入脑出血组,另取尸检的非脑出血病例18例纳入对照组。收集患者临床资料;检测血肿周围脑组织及对照组正常脑组织中的miR-146a及自噬基因Beclin-1、组织蛋白酶D(Cathepsin D)、微管相关蛋白1轻链3(LC3)-Ⅱ/LC-Ⅰ的表达;脑出血组患者出院后随访3个月,并根据改良Rankin评分量表评分(mRS)分为预后不良组187例和预后良好组117例;采用ROC曲线分析miR-146a对预后的预测价值,采用Logistic回归分析预后的影响因素。结果:脑出血组血肿周围脑组织中miR-146a的表达水平明显低于对照组,自噬基因Beclin-1、Cathepsin D、LC3-Ⅱ/LC-Ⅰ的表达水平明显高于对照组(P<0.05)且miR-146a与Beclin-1、Cathepsin D、LC3-Ⅱ/LC-Ⅰ呈负相关;脑出血组中预后良好患者与预后不良患者比较,入院时NIHSS评分、白细胞计数、入院即刻血糖、血肿体积、破入脑室及miR-146a、Beclin-1、Cathepsin D、LC3-Ⅱ/LC-Ⅰ表达水平的差异有统计学意义(P<0.05);经ROC曲线分析,miR-146a的表达对脑出血组患者的预后具有预测价值;经Logistic回归分析,NIHSS评分、血肿体积、破入脑室、miR-146a、Beclin-1是脑出血组患者预后的影响因素(P<0.05)。结论:miR-146a在高血压脑出血的血肿周围脑组织中低表达且与自噬过度激活、短期预后不良有关。
Objective:To study the relationship between the expression of miR-146a in perihematomal brain tissue and autophagy and short-term prognosis in patients with hypertensive intracerebral hemorrhage(ICH).Methods:A total of 204 patients with hypertensive ICH who underwent hematoma clearance in our hospital and were followed up for 3 months were selected as the ICH group.Another 18 non-cerebral hemorrhage cases from autopsies were selected as the control group.Clinical data from patients were collected.The expression of miR-146a,autophagic gene Beclin-1,Cathepsin D,and LC3-Ⅱ/LC3-Ⅰ in perihematomal brain tissue and normal brain tissue was detected.Three months after discharge,the patients in the ICH group were divided into 187 poor prognosis patients and 117 good prognosis patients based on the modified Rankin Scale(mRS)score.The predictive value of miR-146a on prognosis was analyzed by ROC curve,and the influencing factors were analyzed by Logistic regression.Results:The expression level of miR-146a in perihematomal brain tissue of the ICH group was significantly lower than that of the control group;the expression levels of autophagy gene Beclin-1,Cathepsin D,and LC3-Ⅱ/LC3-Ⅰ were significantly higher than those of the control group(P<0.05),and miR-146a was negatively correlated with Beclin-1,Cathepsin D,and LC3-Ⅱ/LC3-Ⅰ.The difference in NIHSS score at admission,WBC,ABG at admission,hematoma volume,ventricular rupture,and expression levels of miR-146a,Beclin-1,Cathepsin D,and LC3-Ⅱ/LC3-Ⅰbetween poor prognosis patients and good prognosis patients in ICH group were statistically significance(P<0.05).ROC curve analysis showed that the expression of miR-146a had predictive value for the prognosis of patients with ICH;Logistic regression analysis showed that the NIHSS score,hematoma volume,ventricular rupture,miR-146a,and Beclin-1 were the influencing factors for prognosis in the ICH group(P<0.05).Conclusion:Expression of miR-146a decreases in the perihematomal brain tissue following hypertensive ICH and is related to the hyperactivity of autophagy and poor short-term prognosis.
作者
陆飞宇
王文宏
李剑侠
黄先锋
林小祥
LU Fei-yu;WANGWen-hong;LI Jian-xia;HUANG Xian-feng;LIN Xiao-xiang(Department of neurosurgery,ZhongDa Hospital Southeast University,Nanjing 210043,China)
出处
《神经损伤与功能重建》
2022年第4期199-203,共5页
Neural Injury and Functional Reconstruction
关键词
高血压脑出血
MIR-146A
自噬
预后
影响因素
hypertensive intracerebral hemorrhage
miR-146a
autophagy
prognosis
influencing factors
