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脑出血疾病患者脑脊液中NSE、S100β及miR-124-3p、miR-146a-5p检测的临床意义 预览

Clinical significance of detection of NSE,S100β,miR-124-3p and miR-146a-5p in cerebrospinal fluid of patients with cerebral hemorrhage
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摘要 目的 探讨脑出血疾病患者脑脊液(CSF)中神经元特异性烯醇化酶(NSE)、酸性钙结合蛋白(S100β)及差异表达的miRNA在疾病诊断与病情评估中的价值。方法 选择脑出血(ICH)疾病患者26例,依据格拉斯哥评分(GCS)将其分为轻度ICH组(13例)、重度ICH组(13例),并选取22例同期排除脑部疾病住院病人作为对照,采用实时荧光定量PCR检测所有入组对象CSF样本中的15个靶标微小RNA(miRNA),同时采用生化及化学发光方法检测β2微球蛋白(β2-MG)、天门冬氨酸氨基转移酶(AST)、乳酸(LAC)、乳酸脱氢酶(LD)、微量清蛋白(mAlb)、NSE、S100β,统计分析上述指标在诊断脑出血的效能及评估病情中的价值。结果 轻度ICH组CSFNSE:17.48(8.64,26.86)ng/mL,S100β:1.40(0.38,2.11)μg/L,重度ICH组CSFNSE:18.55(8.86,24.69)ng/mL,S100β:1.51(1.10,4.64)μg/L,明显高于对照组[NSE:2.93(2.48,3.83)ng/mL,S100β:0.43(0.25,0.88)μg/L],差异有统计学意义(P<0.05);ICH患者CSFNSE的水平与出血量显著相关(r=0.86;P<0.01);与对照组比较,ICH组CSFmiR-124-3p和miR-146a-5p显著上调,差异有统计学意义(P<0.05)。CSF中NSE、S100β、miR-124-3p、miR-146a-5p诊断ICH的曲线下面积(AUC)分别为0.931[95%置信区间(95%CI):0.857~0.892]、0.795(95%CI:0.670~0.921)、0.667(95%CI:0.512~0.822)和0.878(95%CI:0.776~0.844)。CSF中NSE、S100β两者联合诊断ICH的AUC为0.945,灵敏度为84.6%,特异度为98.2%。结论 CSF中NSE、S100β、miR-124-3p、miR-146a-5p的检测对于ICH的辅助诊断具有一定价值,尤其NSE、S100β可反映脑组织损伤严重程度。 Objective To investigate the value of neuron-specific enolase (NSE),acidic calcium-binding protein (S100β) and differentially expressed miRNA in cerebrospinal fluid (CSF) in patients with cerebral hemorrhage disease in disease diagnosis and disease assessment. Methods 26 patients with cerebral hemorrhage (ICH) disease were enrolled and divided into mild ICH group (13 cases) and severe ICH group (13 cases) according to Glasgow score (GCS).22 patients who were excluded from brain diseases in the same period were selected as the control group.Biochemical and chemiluminescence methods were used to detect β 2 microglobulin (β 2-MG),aspartate aminotransferase (AST),lactic acid (LAC),lactate dehydrogenase (LD),microalbumin (mAlb),NSE,S100β.The efficacy of the above indicators in the diagnosis of cerebral hemorrhage and the value in the assessment of the condition were analyzed. Results CSF NSE in the mild ICH group was 17.48 (8.64,26.86) ng/mL,S100β was 1.40 (0.38,2.11)μg/L.CSF NSE in severe ICH group was 18.55 ( 8.86 ,24.69) ng/mL,S100β was 1.51 (1.10,4.64) ug/L,which were significantly higher than those in the control group [NSE:2.93 (2.48,3.83) ng/mL,S100β: 0.43 (0.25,0.88)μg/L],and the differences were statistically significant ( P <0.05);The level of CSF NSE in patients with ICH was significantly correlated with the amount of bleeding ( r =0.86, P <0.01).Compared with the control group,CSF miR-124-3p and miR-146a-5p were significantly up-regulated in the ICH group,and the differences were statistically significant ( P < 0.05).The area under curve (AUC) of ICH in NSE,S100β,miR-124-3p,and miR-146a-5p in CSF were 0.931 [95% confidence interval (95% CI ):0.857-0.892],0.795(95% CI :0.670-0.921),0.667(95% CI : 0.512- 0.822) and 0.878 (95% CI :0.776-0.844).The AUC of combined diagnosis of NSE and S100β in CSF for ICH was 0.945,the sensitivity was 84.6%,and the specificity was 98.2%. Conclusion The detection of NSE,S100β,miR-124-3p and miR-146a-5p in CSF has certain value for the auxiliary diagnosis of ICH,espe
作者 杨奇 史清海 牛莉莉 王黎 李凯 邓梦芸 胡慧婷 伏建峰 YANG Qi;SHI Qinghai;NIU Lili;WANG Li;LI Kai;DENG Mengyu;HU Huiting;FU Jianfeng(School of Medicine,Shihezi University,Shihezi,Xinjiang 832002,China;National Military Clinical Diagnosis Center,General Hospital of Xinjiang Military Command,Urumqi,Xinjiang 830000,China;Department of Clinical Laboratory,Changji People′s Hospital,Changji,Xinjiang 831100,China)
出处 《国际检验医学杂志》 CAS 2019年第11期1302-1307,共6页 International Journal of Laboratory Medicine
基金 国家自然科学基金项目(81871020) 全军后勤科研计划面上项目(CLZ15C005)。
关键词 脑出血 神经元特异性烯醇化酶 S100Β 微小RNA 诊断 cerebral hemorrhage neuron-specific enolase S100β miRNA diagnosis
作者简介 杨奇,男,硕士研究生在读,主要从事脑损伤标志物方面的研究;通信作者:伏建峰,E-mail:dxpjf@163.com。
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