miR-93、miR-191、 miR-499在颅脑损伤患者血清中的表达及其临床意义

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。

The expression and clinical significance of miR-93,miR-191,miR-499 in the serum of patients with traumatic brain injury

ObjectiveTo investigate the expression and clinical significance of miR-93, miR-191, miR-499 in the serum of patients with traumatic brain injury(TBI).Methods Quantitative real-time polymerase chain reaction(qRT-PCR)was used to evaluate these miRNAs levels of TBI patients(n=96)and healthy controls(n=49), who admitted in our hospital from Sep. 2010 to Sep. 2015,and the severity and clinical outcome of TBI was further analyzed.Results The serum miR-93, miR-191, and miR-499 levels significantly elevated in the TBI patients compared with the controls and these levels were much higher in the patients with severe TBI than those with moderate or mild TBI(P<0.05); After treatment,the serum miR-93, miR-191, and miR-499 levels were lower in the patients with good outcome than those with poor outcome(p<0.05); The AUCs of miR-93, miR-191, and miR-499 were 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), respectively,all the differences of above had statistical significance.Conclusion miR-93, miR-191, and miR-499 express distinctly in the TBI patients,can be viewed as potentially valuable indicators of the diagnosis, severity, and prognosis of TBI.