摘要
目的分析血清miR-141-3p、miR-130a、miR-29a-3p、miR-210水平预测非创伤性脑出血早期神经功能恶化(early neurological deterioration,END)的价值。方法采用便利抽样法前瞻性选取2021年2月-2022年10月承德市中心医院收治入院且符合选择标准的非创伤性脑出血患者,收集患者入院时血清miR-141-3p、miR-130a、miR-29a-3p、miR-210水平以及24 h内神经功能恶化发生情况等信息,根据患者是否出现神经功能恶化将其分为恶化组与非恶化组,分析血清miR-141-3p、miR-130a、miR-29a-3p、miR-210水平与非创伤性脑出血END的相关性及其预测价值。结果共纳入235例患者。入院后24 h内45例(19.1%)出现神经功能恶化,190例(80.9%)未出现神经功能恶化。恶化组患者miR-141-3p、miR-29a-3p水平明显低于非恶化组[(1.11±0.32)vs.(1.76±0.51)ng/mL,P<0.001;(1.19±0.31)vs.(1.71±0.51)ng/mL,P<0.001],miR-130a、miR-210水平明显高于非恶化组[(5.13±1.11)vs.(3.82±1.03)ng/mL,P<0.001;(3.96±0.76)vs.(2.78±0.50)ng/mL,P<0.001]。多因素logistic回归分析结果显示,血清miR-141-3p、miR-29a-3p水平是非创伤性脑出血END发生的保护因素[比值比(odds ratio,OR)=0.513,95%置信区间(confidence interval,CI)(0.330,0.798),P=0.003;OR=0.582,95%CI(0.380,0.893),P=0.013],血清miR-130a、miR-210水平是非创伤性脑出血END发生的独立危险因素[OR=2.046,95%CI(1.222,3.426),P=0.007;OR=2.377,95%CI(1.219,4.638),P=0.011]。用logistic回归获得血清miR-141-3p、miR-130a、miR-29a-3p、miR-210水平预测非创伤性脑出血END的联合概率,其预测非创伤性脑出血END的受试者操作特征曲线下面积为0.857[95%CI(0.760,0.954)],根据联合检测的预测概率截断值判定非创伤性脑出血END的灵敏度为86.7%,特异度为94.7%,阳性预测值为79.6%,阴性预测值为96.8%。结论血清miR-141-3p、miR-130a、miR-29a-3p、miR-210的联合检测在非创伤性脑出血END的发生中具有较高的预测价值。
Objective To analyze the value of serum levels of miR-141-3p,miR-130a,miR-29a-3p,and miR-210 in predicting early neurological deterioration(END)in non-traumatic intracerebral hemorrhage.Methods The patients with non-traumatic cerebral hemorrhage who met the selection criteria and were admitted to Chengde Central Hospital between February 2021 and October 2022 were prospectively selected by convenience sampling method.The serum miR-141-3p,miR-130a,miR-29a-3p,and miR-210 levels upon admission and the occurrence of neurological deterioration within 24 h were collected,and the patients were divided into a deterioration group and a non-deterioration group according to whether neurological deterioration occurred.The correlation of serum miR-141-3p,miR-130a,miR-29a-3p,and miR-210 levels with the END of non-traumatic intracerebral hemorrhage and their predictive value to the END of non-traumatic intracerebral hemorrhage were analyzed.Results A total of 235 patient were enrolled.Of the 235 patients,45(19.1%)showed neurological deterioration and 190(80.9%)showed no neurological deterioration.The levels of miR-141-3p and miR-29a-3p in the deteriorating group were significantly lower than those in the non-deteriorating group[(1.11±0.32)vs.(1.76±0.51)ng/mL,P<0.001;(1.19±0.31)vs.(1.71±0.51)ng/mL,P<0.001],and the levels of miR-130a and miR-210 were significantly higher than those in the non-deteriorating group[(5.13±1.11)vs.(3.82±1.03)ng/mL,P<0.001;(3.96±0.76)vs.(2.78±0.50)ng/mL,P<0.001].Multivariate logistic regression analysis showed that serum miR-141-3p and miR-29a-3p levels were protective factors for the occurrence of END in non-traumatic intracerebral hemorrhage patients[odds ratio(OR)=0.513,95%confidence interval(CI)(0.330,0.798),P=0.003;OR=0.582,95%CI(0.380,0.893),P=0.013],and serum miR-130a and miR-210 levels were independent risk factors for that[OR=2.046,95%CI(1.222,3.426),P=0.007;OR=2.377,95%CI(1.219,4.638),P=0.011].The area under the receiver operating characteristic curve was 0.857[95%CI(0.760,0.954)]in predicting the END of non-traumatic intracerebral hemorrhage by the combined probability of the serum miR-141-3p,miR-130a,miR-29a-3p,and miR-210 levels obtained by logistic regression,and the sensitivity was 86.7%,the specificity was 94.7%,the positive predictive value was 79.6%,and the negative predictive value was 96.8%according to the cut-off value of the prediction probability of the combined test.Conclusion The combined detection of serum miR-141-3p,miR-130a,miR-29a-3p,and miR-210 has a high predictive value in the occurrence of END in non-traumatic intracerebral hemorrhage patients.
作者
王久吉
郭红民
赵海洋
杨进飞
张江涛
WANG Jiuji;GUO Hongmin;ZHAO Haiyang;YANG Jinfei;ZHANG Jiangtao(Emergency Department,Chengde Central Hospital,Chengde,Hebei 067000,P.R.China;Department of Orthopedics for Severe Trauma,Affiliated Hospital of Chengde Medical College,Chengde,Hebei 067000,P.R.China;Department of Neurology,Chengde Central Hospital,Chengde,Hebei 067000,P.R.China)
出处
《华西医学》
CAS
2023年第5期704-709,共6页
West China Medical Journal
基金
河北省重点研发计划项目(20377764D)。
