目的:探讨分析重度颅脑损伤患者外周血lncRNA-17A表达与机体Th1/Th2平衡及患者预后相关性。方法:选择2017年1月至2019年12月诸暨市人民医院收治的重度颅脑损伤患者85例作为病例组，再选择同期在本院健康体检的健康志愿者50例作为对照组，检测两组受试者外周血lncRNA-17A、Th1/Th2平衡相关因子(IFN-γ、IL-4、IFN-γ/IL-4)表达情况，进行相关性分析。实时荧光定量PCR(qRT-PCR)检测不同预后患者lncRNA-17A水平差异，应用受试者工作特征(ROC)曲线分析lncRNA-17A对患者不良预后的预测价值。结果:病例组患者外周血lncRNA-17A相对表达量显著高于对照组(n P<0.05)。病例组患者IFN-γ以及IFN-γ/IL-4比值显著低于对照组(n P<0.05)，而IL-4显著高于对照组(n P<0.05)。重度颅脑损伤患者外周血lncRNA-17A水平与GCS评分、IFN-γ/IL-4呈负相关(n r＝-0.336，-0.325，n P<0.05)，与IL-4水平呈正相关(n r＝0.375，n P0.05)。死亡组患者外周血lncRNA-17A相对表达量显著高于存活组(n P<0.05)。采用ROC曲线分析患者外周血lncRNA-17A水平对患者不良预后的预测价值，ROC曲线下面积为0.946。n 结论:重度颅脑损伤患者外周血lncRNA-17A异常升高，且lncRNA-17A表达与患者病情严重程度及Th/1Th2漂移程度有关，可作为预测患者不良预后的潜在指标，值得临床关注。“,”Objective:To analyze the relationship between the peripheral blood lncRNA-17A and the balance of Th1/Th2 in patients with severe brain injury and the prognosis of patients.Methods:85 patients with severe craniocerebral injury admitted to Zhuji People's Hospital from January 2017 to December 2019 were selected as the case group, and 50 healthy volunteers in our hospital at the same time were selected as the control group. The expression of lncRNA-17A, Th1/Th2 balance related factors [interferon- γ (IFN- γ), interleukin (IL)-4, IFN-γ/IL-4] in peripheral blood of the two groups were detected, and the correlation analysis was carried out. LncRNA-17A of patients with different prognosis was detected by real time fluorescent quantitative polymerase chain reaction (qRT-PCR). Receiver operating characteristic curve (ROC) was used to analyze the predictive value of lncRNA-17A to the adverse prognosis of patients.Results:The relative expression of lncRNA-17A in the peripheral blood of the case group was significantly higher than that of the control group (n P<0.05). The IFN-γ and the ratio of IFN-γ/IL-4 in the case group were lower than those in the control group (n P<0.05), while the IL-4 was higher than that in the control group (n P<0.05), with statistically significant difference. There was a significant negative correlation between lncRNA-17A and Glasgow coma score (GCS) score, IFN-γ/IL-4 (n r=-0.336, -0.325, n P<0.05), and positively correlated with IL-4 (n r=0.375, n P0.05). The relative expression of lncRNA-17A in the dead group was significantly higher than that in the living group (n P<0.05). ROC curve was used to analyze the predictive value of lncRNA-17A level in patients′ peripheral blood for poor prognosis, and the area under ROC curve was 0.946.n Conclusions:The abnormal increase of lncRNA-17A in the peripheral blood of patients with severe craniocerebral injury are related to the severity of the disease and the Th1/Th2 drift degree, and they can be used as potential index to predict the adverse prognosis of patients, which deserves clinical attention.