[1]贾祎佳,陆廷盛,姚书眈,等.脊柱骨折并发脊髓损伤患者血清miRNA-133a 和核苷酸结合寡聚化结构域样受体蛋白3 表达水平及其与预后的相关性研究[J].现代检验医学杂志,2023,38(02):1-6,42.[doi:10.3969/j.issn.1671-7414.2023.02.001 ]
　JIA Yi-jia,LU Ting-sheng,YAO Shu-dan,et al.Expression Levels of miRNA-133a, Nucleotide Binding Oligomerization Domain-like Receptor Protein 3 in Serum of Patients with Spinal Fracture Complicated with Spinal Cord Injury and Their Correlation with Prognosis[J].Journal of Modern Laboratory Medicine,2023,38(02):1-6,42.[doi:10.3969/j.issn.1671-7414.2023.02.001 ]
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脊柱骨折并发脊髓损伤患者血清miRNA-133a 和核苷酸结合寡聚化结构域样受体蛋白3 表达水平及其与预后的相关性研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年02期
页码:
1-6,42
栏目:
论著
出版日期:
2023-03-15

文章信息/Info

Title:
Expression Levels of miRNA-133a, Nucleotide Binding Oligomerization Domain-like Receptor Protein 3 in Serum of Patients with Spinal Fracture Complicated with Spinal Cord Injury and Their Correlation with Prognosis
文章编号:
1671-7414（2023）02-001-07
作者:
贾祎佳，陆廷盛，姚书眈，杨建文，姬林松，杨再松，罗春山
（贵州省骨科医院脊柱科，贵阳 550014）
Author(s):
JIA Yi-jia, LU Ting-sheng, YAO Shu-dan, YANG Jian-wen, JI Lin-song, YANG Zai-song, LUO Chun-shan
（Department of Spine Surery，Guizhou Provincal Orthopedics Hospital, Guiyang 550014, China）
关键词:
脊柱骨折; 脊髓损伤; 微小核糖核酸 -133a; 核苷酸结合寡聚化结构域样受体蛋白 3
分类号:
R688.2；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.02.001
文献标志码:
A
摘要:
目的 探究脊柱骨折并发脊髓损伤（spinal cord injury，SCI）患者血清微小 RNA（microRNA，miR）-133a和核苷酸结合寡聚化结构域样受体蛋白 3（nucleotide-binding oligomerization domain-like receptors protein 3，NLRP3）表达水平及其与预后的关系。方法 选取 2019年 1月～2022年 3月在贵州省骨科医院治疗的 90例脊柱骨折并发 SCI患者作为并发 SCI组，统计手术后 3个月患者预后情况，并依据预后分为预后良好组和预后不良组；另以同期单纯脊柱骨折患者 90例作为对照组，记录患者一般资料。采用酶联免疫吸附试验（enzyme-linked immunosorbent assay，ELISA）检测脊柱骨折患者血清 NLRP3水平，采用实时荧光定量 PCR（quantitative real-time PCR，qRT-PCR）法检测 miR-133a水平；受试者工作特征（receiver operating characteristic，ROC）曲线分析血清 miR-133a和 NLRP3水平预测脊柱骨折并发 SCI患者预后的价值；采用多因素 Logistic回归分析脊柱骨折并发 SCI患者预后不良的影响因素。结果 与对照组比较，并发 SCI组血清 miR-133a水平（0.68±0.19 vs 1.01±0.24）降低， NLRP3水平（136.42±32.78 pg/ml vs 86.35±15.95 pg/ml）升高，差异具有统计学意义（t=10.227，13.030，均 P<0.001）。与预后良好组比较，预后不良组椎管侵占率≥ 50%比例（64.71% vs 23.21%）、受伤至激素类药物使用时间 ≥ 8 h比例（70.59% vs 25.00%）、Frankel分级 A级比例（41.18% vs 1.79%）和血清 NLRP3水平（162.11±46.74 pg/ml vs 120.82±29.75 pg/ml）升高， miR-133a水平（0.58±0.14 vs 0.74±0.18）降低，差异均具有统计学意义（t=4.430~45.267，均 P<0.001）。ROC分析显示，血清 miR-133a，NLRP3及二者联合预测脊柱骨折并发 SCI患者预后不良的曲线下面积（area under the curve，AUC）为 0.779（95%CI: 0.681～0.877），0.770（95%CI: 0.673～0.868）和 0.834（95%CI: 0.750～0.918）。Logistic回归结果显示，miR-133a[OR（95%CI）=0.824（0.727～0.934）]、NLRP3[OR（95%CI）=2.673（1.359～5.256）]、椎管侵占率 ≥ 50%[OR（95%CI）=1.562（1.146～2.129）]和受伤至激素类药物使用时间≥ 8h[OR（95%CI）=1.305（1.009～1.687）]均是脊柱骨折并发 SCI患者发生预后不良的独立影响因素（均 P＜ 0.05）。结论 脊柱骨折并发 SCI患者血清 NLRP3水平较高，miR-133a水平较低，与预后密切相关，两者联合对脊柱骨折并发 SCI患者预后有较高预测效能。
Abstract:
Objective To explore the expression levels of micro RNA(miR)-133a and nucleotide-binding oligomerization domain-like receptor 3 (NLRP3) in serum of patients with spinal cord injury(SCI) complicated spinal fracture and its relationship with prognosis. Methods A total of 90 patients with spinal fractures combined with SCI who were treated in Guizhou Provincal Orthopedics Hospital from January 2019 to March 2022 were selected as the combined SCI group. The prognosis of the patients 3 months after the operation was counted. They were divided into a good prognosis group and a poor prognosis group according to the prognosis. In addition, 90 patients with simple spinal fracture during the same period were selected as the control group, and the general data of the patients were recorded. The level of serum NLRP3 in patients with spinal fractures was detected by enzyme-linked immunosorbent assay (ELISA), and the level of miR-133a was detected by quantitative real-time PCR (qRT-PCR) method. Receiver operating characteristic (ROC) curve was drawn to analyze the value of serum miR-133a and NLRP3 levels in predicting the prognosis of patients with spinal fractures complicated with SCI, and multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in patients with spinal fractures complicated with SCI. Results Compared with the control group, the serum miR-133a level in the SCI group was decreased (0.68±0.19 vs 1.01±0.24), and the NLRP3 level was increased (136.42±32.78 pg/ml vs 86.35±15.95 pg/ml), and the difference was statistically significant (t=10.227, 13.030, all P<0.001). Compared with the group with good prognosis, the spinal canal invasion rate ≥ 50% (64.71% vs 23.21%), duration of hormone drug use ≥ 8 h from injury (70.59% vs 25.00%), Frankel grade A (41.18% vs 1.79%), the serum NLRP3 levelin the poor prognosis groupwere increased (162.11±46.74 pg/ml vs 120.82±29.75 pg/ml), and the miR-133a level in the poor prognosis groupwas decreased (0.58±0.14 vs 0.74±0.18), and the differences were statistically significant (t=4.430~45.267, all P<0.001). ROC analysis showed that the area under the curve (AUC) of serum miR-133a, NLRP3 and their combination in predicting poor prognosis in patients with spinal fractures and SCI were 0.779 (95%CI:0.681~0.877) and 0.770 (95%CI:0.673~0.868), 0.834 (95%CI:0.750~0.918).The results of Logistic regression showed that miR-133a[OR(95%CI)=0.824(0.727~0.934)], NLRP3[OR (95%CI) =2.673 (1.359~5.256) ], spinal canal invasion rate ≥ 50%[OR(95%CI)=1.562(1.146~2.129) ], and the time from injury to hormone use ≥ 8 h [OR(95%CI)=1.305(1.009~1.687)] were independent influencing factors for poor prognosis in patients with spinal fractures complicated with SCI(all P<0.05). Conclusion Serum NLRP3 levels were higher and miR-133a levels were lower in patients with spinal fractures combined with SCI, which were closely related to prognosis. The combination of the two have high predictive performance on the prognosis of patients with spinal fractures combined with SCI.

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备注/Memo

备注/Memo:
收稿日期：2022-10-25修回日期：2022-12-08
基金项目：贵州省科技计划项目（编号：黔科合基础 -ZK[2022]一般 231）。
作者简介：贾祎佳（1985-），男，博士研究生，副主任医师，主要从事脊髓损伤的干细胞治疗， E-mail：jiayijia 2192@163.com。
通讯作者：罗春山，E-mail：279432964@qq.com。

更新日期/Last Update: 2023-03-15