Clinical Skills Training Center, Affiliated Hospital of Weifang Medical University, Shandong, 261031, China.
Department of Neurology, Affiliated Hospital of Weifang Medical University, Shandong, 261031, China.
Ir J Med Sci. 2022 Aug;191(4):1607-1612. doi: 10.1007/s11845-021-02745-6. Epub 2021 Aug 30.
The diagnostic and prognostic value of microRNAs (miRNA) in human disease has been confirmed in a number of clinical studies.
The purpose of this study was to investigate the predictive value of miR-191-5p in the neurological outcome of patients recovering from out-of-hospital cardiac arrest (OHCA).
A total of 260 patients undergoing the target temperature management trial were analyzed. The expression level of serum miR-191-5p was detected by qRT-PCR at 48 h after return of spontaneous circulation (ROSC). ROC curve was established to evaluate the ability of miR-191-5p as a biomarker for predicting adverse neurological outcomes after OHCA. Kaplan-Meier curve and Cox regression analysis were used for survival analysis.
One hundred eighteen patients (45%) had poor neurological outcomes at 6 months. The expression level of serum miR-191-5p in patients with poor neurological outcomes was significantly lower than that in patients with good neurological prognosis (P < 0.001) and was not associated with TTM trial. The AUC, sensitivity, and specificity of the ROC curve were 0.899, 84.7%, and 82.4%, respectively, suggesting that the level of miR-191-5p had the ability to predict neurological outcome. By the end of the experiment, 88 patients (34%) were dead. Results of survival analysis showed that lower miR-191-5p expression level was significantly associated with lower survival rate (HR: 0.344, 95% CI = 0.208-0.567, P < 0.001).
The level of miR-191-5p was down-regulated in patients with poor neurological outcomes, and it could be used as a promising novel biomarker for prediction of neurological outcome and survival after OHCA.
在许多临床研究中已经证实了 microRNAs（miRNA）在人类疾病中的诊断和预后价值。
本研究旨在探讨血清 miR-191-5p 在院外心脏骤停（OHCA）患者神经功能恢复预后中的预测价值。
共分析了 260 例行目标温度管理试验的患者。在自主循环恢复（ROSC）后 48 h 通过 qRT-PCR 检测血清 miR-191-5p 的表达水平。绘制 ROC 曲线评估 miR-191-5p 作为 OHCA 后不良神经结局预测生物标志物的能力。采用 Kaplan-Meier 曲线和 Cox 回归分析进行生存分析。
118 例（45%）患者在 6 个月时神经预后不良。神经预后不良患者血清 miR-191-5p 表达水平显著低于神经预后良好患者（P < 0.001），与 TTM 试验无关。ROC 曲线的 AUC、敏感性和特异性分别为 0.899、84.7%和 82.4%，提示 miR-191-5p 水平具有预测神经结局的能力。实验结束时，88 例（34%）患者死亡。生存分析结果表明，miR-191-5p 表达水平较低与生存率降低显著相关（HR：0.344，95%CI=0.208-0.567，P < 0.001）。
神经预后不良患者血清 miR-191-5p 水平下调，可作为预测 OHCA 后神经结局和生存的有前途的新型生物标志物。
