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目的探讨miR-93、miR-191、miR-499在创伤性脑损伤患者中的表达情况及其临床意义。方法采用实时荧光定量聚合酶链反应(quantitative real-time polymerase chain reaction,qRT-PCR)方法检测本院2010年9月~2015年9月收治的96例创伤性脑损伤患者以及招募的49例健康者中miR-93、miR-191、miR-499的表达水平,分析其与脑损伤的损伤程度、临床疗效以及诊断价值的关系。结果 miR-93、miR-191、miR-499在创伤性脑损伤患者血清中的表达水平明显高于对照组(P<0.05);轻度,中度和重度三种不同程度脑损伤患者血清中miR-93、miR-191、miR-499水平都显著性上升,差异具有统计学意义(P<0.05);而且重度脑损伤患者血清中的miRNAs水平最高;治疗后临床疗效好的患者血清中miR-93,miR-191,miR-499水平显著低于临床疗效差的患者,差异具有统计学意义(P<0.05);miR-93,miR-191,miR-499三种miRNAs ROC曲线下面积(area under the curve,AUC)分别为0.952 0(95%CI,0.906 5~0.997 4;P<0.001),0.874 6(95%CI,0.793 3~0.955 8;P<0.001),0.780 7(95%CI,0.671 9~0.889 5;P<0.001)。结论 miR-93,miR-191,miR-499在创伤性脑损伤患者中高表达,可以作为创作性脑损伤患者的预后和损伤程度指标以及诊断靶标。
Objective To investigate the expression of miR-93, miR-191 and miR-499 in patients with traumatic brain injury and its clinical significance. Methods Ninety-six patients with traumatic brain injury and 49 healthy subjects recruited from September 2010 to September 2015 in our hospital were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR) The expression levels of miR-93, miR-191 and miR-499 were analyzed to analyze the relationship between the expression of miR-93, miR-499 and the extent of injury, clinical efficacy and diagnostic value. Results The expression levels of miR-93, miR-191 and miR-499 in patients with traumatic brain injury were significantly higher than those in the control group (P <0.05). The levels of serum in patients with mild, moderate and severe brain injury miR-93, miR-191, miR-499 levels were significantly increased, the difference was statistically significant (P <0.05); and serum levels of miRNAs in patients with severe brain injury were the highest; The levels of miR-93, miR-191 and miR-499 in patients with poor clinical efficacy were significantly different (P <0.05). The area under the ROC curve of miR-93, miR- (95% CI, 0.906 5-0.997 4; P <0.001), 0.874 6 (95% CI 0.793 3-0.95 58; P 0.001), 0.780 7 (95% CI, 0.671 9 ~ 0.889 5; P <0.001). Conclusions miR-93, miR-191 and miR-499 are highly expressed in traumatic brain injury patients, which may serve as a prognostic indicator and a diagnostic target for patients with brain injury.