摘要
目的观察癫痫持续状态(SE)患者血清LncRNA-ZFAS1、miR-15a-5p表达变化,分析血清LncRNA-ZFAS1、miR-15a-5p相对表达量对SE患者预后不良的预测效能。方法SE患者100例(SE组)、同期体检健康者68例(对照组),采用实时荧光定量聚合酶链式反应检测受检者血清LncRNA-ZFAS1、miR-15a-5p,通过starBase数据库预测LncRNA-ZFAS1与miR-15a-5p的结合位点。收集SE患者性别、年龄、病程、发作类型、基础疾病、院内并发症、脑组织异常、脑脊液异常、脑电图异常、伴发热、既往癫痫发作史≥2次、癫痫持续时间、机械通气、癫痫持续状态严重程度评分(STESS)、重症监护室时间、住院时间和治疗药物种类等一般资料,并根据格拉斯哥预后量表将SE患者分为不良预后组31例和良好预后组69例,比较不良预后组、良好预后组患者的一般资料及血清LncRNA-ZFAS1、miR-15a-5p相对表达量。以SE患者预后不良为因变量,以单因素分析中有统计学差异的变量为自变量,采用多因素Logistic回归分析法分析SE患者预后不良的危险因素。采用受试者工作特征曲线(ROC)分析血清LncRNA-ZFAS1、miR-15a-5p相对表达量及二者联合对SE患者预后不良的预测效能。结果SE组受检者血清LncRNA-ZFAS1相对表达量高于对照组,miR-15a-5p相对表达量低于对照组(P均<0.05)。SE患者血清LncRNA-ZFAS1、miR-15a-5p相对表达量呈负相关关系(r=-0.742,P<0.001)。LncRNA-ZFAS1与miR-15a-5p的3'非翻译端存在互补序列。不良预后组惊厥性、癫痫持续时间≥1 h、机械通气比例、STESS评分、血清LncRNA-ZFAS1相对表达量高于良好预后组,血清miR-15a-5p相对表达量低于良好预后组(P均<0.05)。惊厥性SE、癫痫持续时间≥1 h、机械通气、STESS评分增加和血清LncRNA-ZFAS1相对表达量升高为SE患者不良预后的独立危险因素,血清miR-15a-5p相对表达量升高为独立保护因素(P均<0.05)。血清LncRNA-ZFAS1预测SE患者不良预后的AUC为0.786,敏感度为67.74%、特异度为75.36%;血清miR-15a-5p预测SE患者不良预后的AUC为0.781,敏感度为90.32%、特异度为53.62%;血清LncRNA-ZFAS1联合miR-15a-5p预测SE患者不良预后的AUC为0.879,敏感度为87.10%、特异度为73.91%。结论SE患者血清LncRNA-ZFAS1高表达、miR-15a-5p低表达,呈负相关关系。血清LncRNA-ZFAS1相对表达量升高为SE患者不良预后的独立危险因素,血清miR-15a-5p相对表达量升高为独立保护因素。检测血清LncRNA-ZFAS1、miR-15a-5p可用于SE患者预后不良的预测,且二者联合预测效能更高。
Objective To observe the changes in the expression levels of serum LncRNA-ZFAS1 and miR-15a-5p in patients with status epilepticus(SE),and to analyze the predictive efficacy of the relative expression of serum LncRNAZFAS1 and miR-15a-5p for the poor prognosis of SE patients.Methods Totally 100 cases of SE patients(SE group)and 68 cases of healthy people with physical examination in the same period(control group)were selected,and real-time fluo‑rescence quantitative polymerase chain reaction was used to detect serum LncRNA-ZFAS1 and miR-15a-5p levels in the subjects,and the binding sites of LncRNA-ZFAS1 and miR-15a-5p were predicted by starBase database.General data such as gender,age,disease duration,seizure type,underlying disease,in-hospital complications,brain tissue abnormal‑ities,cerebrospinal fluid abnormalities,electroencephalogram abnormalities,concomitant fever,history of≥2 previous seizures,duration of epilepsy,mechanical ventilation,status epilepticus severity score(STESS),time in the intensive care unit,length of hospital stay,and types of therapeutic medications were collected from the patients with SE.According to the Glasgow Prognostic Score,the SE patients were divided into the poor prognosis group of 31 cases and the good prog‑nosis group of 69 cases.We compared the general data and the relative expression levels of serum LncRNA-ZFAS1 and miR-15a-5p of the patients in the poor prognosis group and the good prognosis group.Risk factors for poor prognosis in SE patients were analyzed by multifactorial Logistic regression analysis.Using poor prognosis in SE patients as the dependent variable,and variables that were statistically different in univariate analyses as independent variables.The risk factors for poor prognosis in SE patients were analyzed using multivariate Logistic regression analysis.The predictive efficacy of the combination of relative expression of serum LncRNA-ZFAS1 and miR-15a-5p on poor prognosis in SE patients was ana‑lyzed using receiver operating characteristic(ROC)curve.Results The relative expression of serum LncRNA-ZFAS1 in the SE group was higher than that of the control group,and the relative expression of miR-15a-5p was lower than that of the control group(both P<0.05).There was a negative correlation between the relative expression of serum LncRNA-ZFAS1 and miR-15a-5p in the SE patients(r=–0.742,P<0.05).LncRNA-ZFAS1 had a complementary sequence to the 3'un‑translated end of miR-15a-5p.The convulsive SE,seizure duration≥1 h,the proportion of mechanical ventilation,STESS score,and serum LncRNA-ZFAS1 were higher in the poor prognosis group than in the good prognosis group,and the rela‑tive expression of serum miR-15a-5p was lower than that of the good prognosis group(all P<0.05).The AUC of serum Ln‑cRNA-ZFAS1 in predicting poor prognosis of SE patients was 0.786,with a sensitivity of 67.74%and a specificity of 75.36%;the AUC of serum miR-15a-5p in predicting poor prognosis of SE patients was 0.781,with a sensitivity of 90.32%and a specificity of 53.62%;and the AUC of serum LncRNA-ZFAS1 combined with miR-15a-5p in predicting poor prognosis of SE patients was 0.879,with the sensitivity of 87.10%and specificity of 73.91%.Conclusions Se‑rum LncRNA-ZFAS1 is highly expressed and miR-15a-5p is low expressed in SE patients,which shows a negative correla‑tion.Elevated relative expression of serum LncRNA-ZFAS1 is an independent risk factor for poor prognosis of SE patients,and elevated relative expression of serum miR-15a-5p is an independent protective factor.Detection of serum LncRNAZFAS1 and miR-15a-5p can be used for the prediction of poor prognosis in SE patients,and the predictive value of the two combined is higher.
作者
陈倩
韩忠海
宋志刚
黄陈
王华
王海滨
CHEN Qian;HAN Zhonghai;SONG Zhigang;HUANG Chen;WANG Hua;WANG Haibin(Department of Neurology,Ziyang First People's Hospital,Ziyang 641300,China;不详)
出处
《山东医药》
CAS
2024年第21期39-43,共5页
Shandong Medical Journal
基金
四川省卫生健康科研课题项目(20PJ308)。
作者简介
第一作者:陈倩(1988-),女,硕士,主治医师,主要研究方向为神经病学。E-mail:wr1234562023@126.com;通信作者:王海滨(1983-),男,学士,副主任医师,主要研究方向为神经病学。E-mail:17382950827@163.com。
