关键词: 缺血缺氧, 脑； RNA；预后

Abstract: Objective To explore the clinical value of serum miRNA-210 and miRNA-223 in predicting the prognosis of neonatal hypoxic-ischemic encephalopathy (NHIE). 
Methods A total of 124 newborns with NHIE were collected as the observation group. According to the severity of neonatal MRI, they were divided into the mild group (n=51), the moderate group (n=40) and the severe group (n=33), and 60 healthy newborns during the same period were selected as the control group. According to the prognosis within 28 days after birth, the children were divided into a survival group (n=81) and a death group (n=43). Serum microRNA-210 (miRNA-210) and microRNA-223 (miRNA-223) levels were detected by real-time fluorescence quantitative PCR, and the clinical value of its level in predicting the prognosis of NHIE was analyzed. 
Results The expression levels of serum miRNA-210 and miRNA-223 in newborns with NHIE were higher than those in the healthy control group (P＜0.05). and higher in the severe group than in the mild group and the moderate group, and the difference between the groups was statistically significant (P＜0.05). Univariate analysis showed that age at the initation of treatment, Apgar score, severity of hypoxic ischemic encephalopathy, interleukin-6, C-reactive protein, serum miRNA-210 expression, and serum miRNA-223 expression were associated with the prognosis of newborns with NHIE (P＜0.05). The results of multivariate analysis showed that the age at the initation of treatment that was higher than 2.25 days (OR=3.554, 95%CI: 1.300-9.713), non-severity based on the severity of the disease (OR=4.450, 95%CI: 2.189-9.048), and an increase in serum miRNA-210 (OR=3.117, 95%CI: 1.598-6.082) and an increase in serum miRNA-223 (OR=3.384, 95%CI: 1.790-6.398) were independent risk factors affecting the prognosis of newborns with NHIE (P＜0.05). Receiver operating characteristic (ROC) curve analysis showed that when the optimal cut-off value of serum miRNA-210 was 1.71, the area under the ROC curve (AUC) for predicting the prognosis of NHIE was 0.76, the sensitivity was 78.62%, and the specificity was 76.35%. When the optimal cutoff value of miRNA-223 was 1.48, the AUC for predicting the prognosis of NHIE was 0.79, the sensitivity was 81.54%, and the specificity was 76.18%. The AUC of the two indicators in combination for the prognosis of newborns with NHIE was 0.85, with a sensitivity of 86.73% and a specificity of 75.49%. 
Conclusion miRNA-210 and miRNA-223 are elevated in newborns with NHIE, which are closely related to the severity and prognosis of newborns. Increased miRNA-210 and miRNA-223 have good predictive value in the prognosis of children with NHIE. 

Key words: hypoxia-ischemia, brain; , RNA, prognosis