摘要
目的 探究血清微RNA(miRNA)-210、巨噬细胞移动抑制因子(MIF)、动脉血乳酸预测重症颅脑损伤后脑梗死的价值.方法 回顾性选取2020年2月至2023年2月中国人民解放军总医院第二医学中心收治的重症颅脑损伤患者75例作为研究对象,根据患者是否并发脑梗死将患者分为梗死组(n=32)和未梗死组(n=43).收集两组患者的临床资料,并对两组血清miRNA-210、MIF、动脉血乳酸水平差异进行比较.采用受试者操作特征(ROC)曲线分析血清miRNA-210、MIF、动脉血乳酸水平预测重症颅脑损伤后脑梗死的价值.结果 两组在性别、年龄、吸烟饮酒史、高血压史、糖尿病史、受伤原因、有无颅底骨折、是否为多发伤方面比较,差异均无统计学意义(P＞0.05),梗死组患者脑疝、蛛网膜下出血的发生率分别为34.38％、40.63％,均高于未梗死组(13.95％、16.28％),差异均有统计学意义(P＜0.05).梗死组患者的血清miRNA-210、动脉血乳酸水平分别为0.92±0.22、(6.12±0.78)mmol/L,均高于未梗死组患者[0.45±0.12、(4.45±0.61)mmol/L],MIF 水平为(1.02±0.15)ng/mL,低于未梗死组[(1.23±0.12)ng/mL],差异均有统计学意义(P＜0.05).经多因素Logistic回归分析,血清miRNA-210、MIF、动脉血乳酸水平均会对患者合并梗死产生影响(P＜0.05).采用ROC曲线探究血清miRNA-210、MIF、动脉血乳酸水平对患者合并梗死的预测价值,其曲线下面积(AUC)值分别为0.859、0.747、0.835.结论 重症颅脑损伤后脑梗死患者血清中miRNA-210和动脉血乳酸水平降低,MIF水平升高,对脑梗死的预测价值较高,可能为临床提供了 一种新的方法来评估重症颅脑损伤患者发生脑梗死的风险.
Abstract
Objective To investigate the value of serum microRNA(miRNA)-210,macrophage migration inhibitory factor(MIF)and arterial lactate in predicting cerebral infarction after severe craniocerebral injury.Methods Seventy-five patients with severe craniocerebral inju-ry admitted to Second Medical Center,Chinese People's Liberation Army General Hospital from February 2020 to February 2023 were selected as research objects.According to whether the patients were complicated with cerebral infarction,the patients were divided into infarction group(n=32)and non-infarction group(n=43).Clinical data of the two groups patients were collected,and differences in serum miRNA-210,MIF and arterial lactate levels between the two groups were compared.The value of serum miRNA-210,MIF,and arterial blood lactate levels in pre-dicting cerebral infarction after severe traumatic brain injury was analyzed using receiver operating characteristic(ROC)curves.Results There was no statistically significant differences in gender,age,history of smoking and drinking,history of hypertension,history of diabetes,cause of in-jury,skull base fracture or multiple injuries between the two groups(P＞0.05).The incidence rates of cerebral herniation and subarachnoid hemorrhage in the infarcted group were 34.38％and 40.63％,respectively,which were higher than those in the non-infarcted group(13.95％and 16.28％),and the differences were statistically significant(P＜0.05).The serum miRNA-210 and arterial lactate levels in the infarcted group were 0.92±0.22 and(6.12±0.78)mmol/L,respectively,which were higher than those in the non-infarcted group[0.45±0.12 and(4.45±0.61)mmol/L],the MIF level was(1.02±0.15)ng/mL,which was lower than that in the non-infarcted group[1.23±0.12)ng/mL],and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that serum miRNA-210,MIF and Lac levels had significant effects on patients with infarction(P＜0.05).ROC curve was used to investigate the predictive value of serum miRNA-210,MIF and arterial lactate levels in patients with infarction,and their area under the curve(AUC)values were 0.859,0.747 and 0.835,respectively.Conclusion Serum miRNA-210 and arterial lactate levels decreased and MIF levels increased in patients with cerebral in-farction after severe craniocerebral injury,which has a high predictive value for cerebral infarction,may be providing a new method for clinical as-sessment of the risk of cerebral infarction in patients with severe craniocerebral injury.
NETL
NSTL
维普
万方数据