缺血缺氧性脑病新生儿microRNA-21表达及临床价值

Clinical value of microRNA-21 in neonatal hypoxic ischemic encephalopathy

摘要:

目的 探讨新生儿缺血缺氧性脑病（HIE）患儿血清microRNA-21（miR-21）表达水平的变化，以及恢复期miR-21与神经行为检测（NBNA）评分的相关性。方法 选取2018年3月—2019年6月西安医学院第二附属医院56例HIE患儿（HIE组）及同期60例正常新生儿（对照组），检测患儿出生后24 h血清miR-21表达水平的差异，进行统计学检验并绘制ROC曲线。检测HIE患儿接受常规治疗7 d后miR-21表达水平及治疗30 d后的NBNA评分，并进行相关性分析。结果 HIE组miR-21表达水平较对照组升高（P <0.05）；血清miR-21对缺氧缺血性脑病的AUC值为0.758（95% CI：67.32，85.78），敏感性为89.47%（95% CI：0.972，2.641），特异性为92.83%（95% CI：0.953，2.487）；HIE患儿治疗7 d后血浆miR-21表达水平与治疗30 d后的NBNA评分呈负相关（r =-0.746，P <0.05）。结论 miR-21对HIE具有早期诊断意义，miR-21对HIE的病情进展具有早期预测效果，为HIE的早期诊断和病情进展提供新的依据和生物学标志物。

Abstract:

Objective To investigate the changes of serum microRNA-21 (miR-21) expression and the correlation between miR-21 and NBNA scores in neonates with hypoxic-ischemic encephalopathy (HIE).Methods Totally 56 children with HIE and 60 normal newborns were enrolled. The difference of plasma miR-21 expression was detected 24 h after birth. Statistical analysis was performed and ROC curve was drawn. Correlation analysis was performed to detect the expression of miR-21 after 7 days of routine treatment and the NBNA score of brain function after 30 days of treatment.Results The expression of miR-21 in the HIE group was significantly higher than that in the control group (P < 0.05). The AUC value of serum miR-21 in hypoxic ischemic encephalopathy was 0.758 (95% CI: 67.32, 85.78), the sensitivity was 89.47% (95% CI: 0.972, 2.641), and the specificity was 92.83% (95% CI: 0.953, 2.487). There was a negative correlation between plasma miR-21 and NBNA scores after 30 days of treatment (r =-0.746, P < 0.05).Conclusion MiR-21 has early diagnostic significance and early predictive effect for HIE. This study provides a new basis and biomarkers for the early diagnosis and progression for HIE.