Clinical significance of combined detection of peripheral miR-182 and IL-17 in the early diagnosis of patients with eclampsia complicated with cerebral infarction in ICU / 中华危重病急救医学

ABSTRACT

Objective To observe the effect of peripheral blood microRNA-182 (miR-182) combined with interleukin-17 (IL-17) in the early diagnosis of cerebral infarction (CI) in patients with eclampsia. Methods A prospective non-randomized controlled study was conducted. The patients with eclampsia admitted to intensive care unit (ICU) of Liaocheng People's Hospital from January 1st, 2013 to September 30th 2016 were enrolled. Cerebral imaging was conducted in 7 days after admission to make a definite diagnosis of the occurrence of CI, excluding patients with cerebral hemorrhage. Patients were divided into CI group and non-CI group. Twenty healthy women of childbearing age were selected as control group. Peripheral venous blood of all patients with eclampsia at 1 day after admission, the expression of miR-182 was detected by real-time fluorescence quantitative polymerase chain reaction (PCR), regulatory T cells (Treg) and T helper 17 cells (Th17) ratio was detected by flow cytometry, and the level of plasma IL-17 was detected by enzyme linked immunosorbent assay (ELISA). Pearson method was used to analyze the correlation between the indexes. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of each index for CI in patients with eclampsia. Results In the 30 patients with eclampsia, there were 13 cases of CI, including 10 case of cerebral venous thrombosis (CVT) and 3 cases of arterial thrombus; 17 cases of non-CI, including 15 cases of reversible posterior leukoencephalopathy syndrome (RPLS) and 2 cases without obvious abnormalities. Compared with control group, the levels of miR-182, Th17% and IL-17 in non-CI group and CI group were significantly higher, and the Treg% was significantly lower. The levels of parameters mentioned above were further increased in CI group than those in non-CI group [miR-182 (2-ΔΔCt) 2.35±0.79 vs. 1.75±0.56, Th17% (5.16±1.89)% vs. (3.93±1.92)%, IL-17 (ng/L)37.45±6.20 vs. 26.65±5.13, all P < 0.05]. Pearson correlation analysis showed that miR-182 was positively correlated with Th17% and IL-17 (r1 = 0.761, r2 = 0.842, both P < 0.01). ROC curves showed that when the cut-off value of miR-182 was 2.88, the diagnosis sensitivity of preeclampsia CI was 84.6%, the specificity was 82.4%, and area under the ROC curve (AUC) was 0.816 [95%CI confidence interval (95%CI) = 0.641-0.992]; when cut-off value of IL-17 was 34.44 ng/L, diagnosis of preeclampsia CI the sensitivity was 71.5%, the specificity was 85.3%, and AUC was 0.773 (95%CI = 0.602-0.945); when miR-182 was combined with IL-17, the diagnosis sensitivity was 92.3%, specificity was 83.6%, and AUC was 0.896 (95%CI = 0.759-1.032). Conclusions To some extent the expression of miR-182 and IL-17 in peripheral blood can predict the occurrence of CI in early stage. When the two are used together, the predictive value is better.