血清microRNA-107、microRNA-22-3p水平与高血压脑出血早期神经功能恶化的关系

The relationship between serum microRNA-107 and microRNA-22-3p levels and early neurological deterioration in hypertensive intracerebral hemorrhage

摘要:

目的 分析血清microRNA-107（miR-107）、microRNA-22-3p（miR-22-3p）水平与高血压脑出血（HICH）早期神经功能恶化（END）的关系。方法 选取2022年3月—2025年6月首都医科大学附属北京安贞医院南充医院收治的98例HICH患者为研究对象。采用实时荧光定量聚合酶链反应检测miR-107、miR-22-3p水平。根据患者是否发生END分为END组（21例）与非END组（77例），比较两组基线资料及miR-107、miR-22-3p水平。采用多因素一般Logistic回归模型分析HICH患者发生END的影响因素。采用点二列相关法分析血清miR-107、miR-22-3p与HICH患者发生END的相关性。绘制受试者工作特征（ROC）曲线分析miR-107、miR-22-3p预测HICH患者发生END的价值。结果 98例HICH患者中，发生END 21例，占21.43%。END组高血压病程、血肿体积、miR-107、miR-22-3p水平均高于非END组（P <0.05），GCS评分低于非END组（P <0.05）。高血压病程长［O^R =3.532（95% CI：1.156，10.791）］、血肿体积大［O^R =1.148（95% CI：1.074，1.226）］、miR-107水平高［O^R =33.809（95% CI：1.809，631.732）］、miR-22-3p水平高［O^R =39.295（95% CI：3.248，475.419）］均为HICH患者发生END的危险因素（P <0.05），GCS评分高［O^R =0.551（95% CI：0.315，0.965）］是HICH患者发生END的保护因素（P <0.05）。血清miR-107、miR-22-3p与HICH患者发生END均呈正相关（r =0.602、0.596，P <0.05）。ROC曲线分析结果显示，血清miR-107、miR-22-3p及二者联合评估HICH患者发生END的敏感性分别为66.7%（95% CI：0.430，0.854）、76.2%（95% CI：0.528，0.918）、85.7%（95% CI：0.637，0.970），特异性分别为75.3%（95% CI：0.642，0.844）、74.0%（95% CI：0.628，0.834）、83.1%（95% CI：0.729，0.907），曲线下面积分别为0.791（95% CI：0.682，0.899）、0.788（95% CI：0.673，0.903）、0.863（95% CI：0.780，0.946）。结论 血清miR-107、miR-22-3p是HICH患者发生END的相关因素，联合检测可更好地预测HICH患者END的发生。

Abstract:

Objective To analyze the relationship between serum levels of microRNA-107 (miR-107), microRNA-22-3p (miR-22-3p) and early neurological deterioration (END) in patients with hypertensive intracerebral hemorrhage (HICH).Methods A total of 98 HICH patients admitted to Beijing Anzhen Nanchong Hospital of Capital Medical University (Nanchong Central Hospital) from March 2022 to June 2025 were selected as the study subjects. The levels of miR-107 and miR-22-3p were detected by quantitative real-time PCR. According to the occurrence of END, patients were divided into the END group (n = 21) and the non-END group (n = 77). The baseline data and levels of miR-107 and miR-22-3p were compared between the two groups. Multivariate logistic regression model was used to analyze the influencing factors of END in HICH patients. Point-biserial correlation was used to analyze the correlation between serum miR-107, miR-22-3p and END occurrence in HICH patients. Receiver operating characteristic (ROC) curve was drawn to analyze the value of miR-107 and miR-22-3p in predicting END in HICH patients.Results Among 98 patients with HICH, 21 cases developed END, accounting for 21.43%. The END group had a longer duration of hypertension, larger hematoma volume, and higher levels of miR-107 and miR-22-3p than the non-END group, while the GCS score was significantly lower (P < 0.05). Multivariate logistic regression analysis identified a long course of hypertension [O^R = 3.532 (95% CI: 1.156, 10.791) ], large hematoma volume [O^R = 1.148 (95% CI: 1.074, 1.226) ], high miR-107 level [O^R = 33.809 (95% CI: 1.809, 631.732) ], and high miR-22-3p level [O^R=39.295 (95% CI: 3.248, 475.419) ] as independent risk factors for END in HICH patients (P < 0.05), a high GCS score was a protective factor [O^R=0.551 (95% CI: 0.315, 0.965), P < 0.05]. Serum miR-107 (r = 0.602, P < 0.05) and miR-22-3p (r = 0.596, P < 0.05) levels were positively correlated with END occurrence. The receiver operating characteristic curve analysis results showed that the sensitivity of serum miR-107, miR-22-3p and their combination for evaluating END in HICH patients was 66.7% (95% CI: 0.430, 0.854), 76.2% (95% CI: 0.528, 0.918), 85.7% (95% CI: 0.637, 0.970), the specificity was 75.3% (95% CI: 0.642, 0.844), 74.0% (95% CI: 0.628, 0.834), 83.1% (95% CI: 0.729, 0.907), the area under the curve was 0.791 (95% CI: 0.682, 0.899), 0.788 (95% CI: 0.673, 0.903), 0.863 (95% CI: 0.780, 0.946), respectively.Conclusion Serum miR-107 and miR-22-3p are factors associated with END in HICH patients. Combined detection can better predict the occurrence of END in HICH patients.