MicroRNA-374a-5p水平与混合型深静脉血栓形成患者临床特征的关系及在预后判断中的价值*

目的 探讨microRNA-374a-5p（miR-374a-5p）水平与混合型深静脉血栓形成（DVT）患者临床特征的关系及在预后判断中的价值。方法 选取2015年1月—2016年12月邯郸市第一医院收治的混合型DVT患者80例作为研究对象，均采用胫前静脉入路溶栓治疗，以患者治疗前miR-374a-5p表达水平中位数为临界值分为高表达组和低表达组，每组40例。以同期60例健康体检者miR-374a-5p表达水平作为参照。比较高表达组和低表达组患者一般资料，治疗后患肢肿胀程度、血栓清除率、静脉通畅度评分，治疗期间并发症发生情况，以及远期随访血栓后综合征（PTS）发生率。结果 DVT患者中miR-374a-5p表达水平高于健康人群（P?<0.05）；高表达组患者年龄、首发症状至就诊时间大于或长于低表达组，有骨科疾病手术史者比例高于低表达组（P?<0.05）。治疗后两组患者患、健侧大小腿周径差减小，但两组患者大小腿消肿率及患肢静脉通畅度评分、血栓清除率差异无统计学意义（P?>0.05）；高表达组和低表达组并发症发生率分别为15.0%和17.5%，差异无统计学意义（P?>0.05）；术后随访2年，高表达组PTS发生率为55.0%（22/40），高于低表达组的32.5%（13/40），且高表达组患者PTS严重程度高于低表达组（P?<0.05）。结论 miR-374a-5p在混合型DVT患者中存在高表达，且其高低表达者间在年龄、首发症状至就诊时间及骨科疾病手术史方面存在差异，miR-374a-5p高表达会增加患者远期PTS发生率及加重严重程度。

Clinical characters and prognostic values of microRNA-374a-5p in patients with mixed deep vein thrombosis*

Objective To investigate and analyze the clinical characters and prognostic values of miR-374a-5p in the patients with mixed DVT. Methods The median of miR-374a-5p expression level before treatment was used as the critical value to divide patients into high expression group and low expression group, with 40 cases in each group. At the same time, the expression levels of miR-374a-5p in 60 healthy subjects were used as control group. Both groups of patients were treated with anterior tibial vein thrombolysis, the general information and degree of swelling of the affected limb, thrombus clearance, venous patency, complications during treatment, and the incidence of long-term follow-up PTS were compared between the two groups. Results The expression level of miR-374a-5p in patients with DVT was significantly higher than the healthy controls (P??0.05). The incidence of complications was 15.0% and 17.5%, respectively (P?> 0.05). After two years of follow-up, the incidence of PTS in the high expression group was 55.0% (22/40), which was significantly higher than that in the low expression group 32.5% (13/40), and the severity of PTS in the high expression group was significantly greater than that in the low expression group (P?< 0.05). Conclusion miR-374a-5p is highly expressed in patients with mixed DVT, and its expression is different in age, first symptom to treatment time and surgical history of orthopedic diseases. High expression of miR-374a-5p will increase the incidence of long-term PTS rate and severity in patients.