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Background:The aim of this work is to detect and compare the peripheral blood miRNA expression profiles in patients with severe traumatic brain injury (sTBI) 2,12,24,48,and 72 h after injury at high altitude and to predict the target genes of differential expressed miRNAs.Methods:Twenty sTBI patients from high-altitude areas were randomly selected according to the inclusion and exclusion criteria and were divided into five groups:the 2-h group,12-h group,24-h group,48-h group,and 72-h group.Peripheral blood miRNA expression profiles were detected using real-time quantitative PCR (qRT-PCR).Results:The expression levels of miR-18a,miR-203,miR-146a,miR-149,miR-23b,and miR-let-7b in peripheral blood showed significant differences between the 2-h group and the 12-h group.The expression levels of miR-203,miR-146a,miR-149,miR-23b,and miR-let-7f in peripheral blood were up-regulated in the 24-h group.In the 48-h group,the expression levels of miR-181d,miR-29a,and miR-18b were upregulated.In the 72-h group,the expression levels of miR-203,miR-146a,miR-149,miR-23b,and miR-let-7f changed.The main target genes of the differentiation expressed miRNAs were genes that regulate inflammatory responses,apoptosis,and DNA damage/repair.Conclusions:miRNAs may be involved in the pathogenesis of sTBI by dynamically regulating the target genes that regulate inflammatory responses,apoptosis,and DNA damage/repair pathways.