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目的 探究急性脑出血(acute cerebral hemorrhage,ACH)患者血清微RNA-23a-3p(microRNA-23a-3p,miR-23a-3p)表达与预后的关系.方法 选择2017年7月—2019年2月在泰州市人民医院接受治疗的85例ACH患者作为研究对象.另择同期67例健康体检者作为对照组.采用实时荧光定量PCR(real-time fluorescence quan?titative PCR,RT-qPCR)法检测两组受试者血清miR-23a-3p表达情况.分析ACH患者血清miR-23a-3p表达与预后的关系.结果 ACH组患者血清miR-23a-3p相对表达量高于对照组,差异有统计学意义(P＜0.05).ACH患者血清miR-23a-3p相对表达量与血肿体积呈正相关关系.85例ACH患者中28例(32.94%)预后不良,57例(67.06%)预后良好.预后不良组患者血清miR-23a-3p相对表达量高于预后良好组患者,差异有统计学意义(P＜0.05).单因素及多因素Logistic回归分析结果显示年龄＞60岁、NIHSS评分＞12.38分、血肿量＞27.93 mL、早期神经功能恶化及miR-23a-3p＞2.92的ACH患者预后不良风险较高.结论 ACH患者血清miR-23a-3p相对表达量升高.检测ACH患者血清miR-23a-3p相对表达量有助于了解其预后.“,”Objective To investigate the relationship between serum microRNA-23a-3p(miR-23a-3p) expression and prognosis in patients with acute cerebral hemorrhage (ACH). Methods Peripheral blood samples were collected from 85 ACH patients (ACH group) and 67 randomly selected healthy subjects (control group).to detect the expression of se?rum miR-23a-3p by real-time fluorescence quantitative PCR(RT-qPCR). Telephone follow-up was conducted month?ly for 6 months. The prognosis was regarded as good if the score of modified Rankin scale (mRS) was≤2 at the last fol?low-up. The relationship between serum miR-23a-3p expression and prognosis was analyzed. Results The relative ex?pression of serum miR-23a-3p was(2.92±0.39), significantly higher than that of the control group [(1.47±0.28),t=26.693,P＜0.001]. The relative expression of serum miR-23a-3p was positively correlated with the hematoma volume (r=0.665,P＜0.001). 28 of the 85 ACH patients (32.94%) had a poor prognosis and 57 (67.06%) had a good prognosis. The relative expression level ofserum miR-23a-3p of the ACH patients with poor prognosis was(3.30±0.18), signifi?cantly higher than that of the patients with good prognosis [(2.73±0.33),t=10.258,P＜0.001]. Univariate and multivar?iate logistic regression analyses showed that the patients aged＞60 years, and with NIHSS score＞12.38, hematoma vol?ume＞27.93 mL, early neurological deterioration, and miR-23a-3p＞2.92 had higher risk of poor prognosis. Conclu?sion The relative expression of serum miR-23a-3p is increased in ACH patients. Detection of the relative expression of serum miR-23a-3p in the ACH patients helps understand the prognosis thereof.