Clinical value of miR-146a combined with NLR in predicting the efficacy of hyperbaric oxygen therapy in patients with hypertensive cerebral hemorrhage
Objective To investigate the clinical value of microRNA-146a(miR-146a)combined with neutrophil-to-lymphocyte ratio(NLR)in predicting the efficacy of hyperbaric oxygen therapy in patients with hypertensive intracerebral hemorrhage.Methods A total of 84 patients with hypertensive intracerebral hemorrhage admitted to Yuncheng Central Hospital from May 2020 to May 2022 were selected by convenient sampling method.All of them underwent percutaneous cone-skull puncture hematoma drainage after admission,and were treated with hyperbaric oxygen after surgery.After three courses of hyperbaric oxygen therapy,the recovery of neurological function in patients was assessed using the National Institutes of Health Stroke Scale(NIHSS)and the Scandinavian Stroke Scale(SSS).A Sysmex automated hematology analyzer was used to measure and calculate the patients'whole blood NLR before and after treatment.The serum levels of miR-146a before and after treatment were detected using quantitative real-time PCR(qRT-PCR).Based on the modified Rankin Scale(mRS),the patients were divided into a group with good treatment outcomes(n=56)and a group with poor treatment outcomes(n=28)after hyperbaric oxygen therapy.The relationship between serum miR-146a levels,NLR,and the different treatment outcomes was analyzed.Receiver operating characteristic(ROC)curves were plotted based on serum miR-146a levels and NLR in patients with different treatment outcomes to evaluate their clinical value in predicting the efficacy of hyperbaric oxygen therapy for hypertensive cerebral hemorrhage.Results After treatment,the NIHSS scores and NLR in patients were significantly lower than those before treatment,while the relative expression of miR-146a and SSS scores were significantly higher than those before treatment.These differences were statistically significant(P＜0.01).In the good treatment efficacy group,the relative expression level of miR-146a after treatment(1.87±0.35)was higher than that in the poor treatment efficacy group(1.22±0.16),and the NLR level(1.62±0.37)was lower than that in the poor treatment efficacy group(3.74±0.68),and the differences were statistically significant(P＜0.01).Before treatment,serum miR-146a was negatively correlated with NIHSS score(r=-0.422)and positively correlated with SSS score(r=0.512).NLR was positively correlated with NIHSS score(r=0.436)and negatively correlated with SSS score(r=-0.459),and the differences were all statistically significant(P＜0.01).The optimal cut-off values of serum miR-146a and NLR for predicting the efficacy of hyperbaric oxygen therapy in patients with hypertensive cerebral hemorrhage were 1.63 and 1.78,respectively.The area under the ROC curve for the combined prediction of the two indicators was 0.81,and the sensitivity and specificity were 83.56％and 68.24％,respectively.Conclusion The decrease of serum miR-146a and the increase of NLR were closely related to the recovery of neurological function and prognosis of patients with hypertensive cerebral hemorrhage after hyperbaric oxygen therapy.Monitoring the change of miR-146a level has important reference value for predicting the efficacy of hyperbaric oxygen therapy in patients with hypertensive cerebral hemorrhage.
Hypertensive cerebral hemorrhageHyperbaric oxygen therapyNeural functionPredictive value
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