急性缺血性脑卒中患者血清长链非编码RNA母系表达基因3和Zeste同源物增强子-2表达与神经功能损伤的相关性分析

Correlation analysis of serum long non-coding RNA maternally expressed gene 3 and enhancer of Zeste homolog 2 expression with neurological function damage in patients with acute ischemic stroke

目的探讨长链非编码RNA(lncRNA)母系表达基因3(MEG3)与Zeste同源物增强子-2(EZH2)在急性缺血性脑卒中(AIS)患者血清中的表达水平及其与神经功能损伤之间的关系。方法选取延安市人民医院2021年1月至2022年11月收治的92例AIS患者为脑卒中组,92例健康体检者为对照组,根据NIHSS评分将脑卒中组患者分为致残性损伤组19例,非致残性损伤组73例。采用实时荧光定量聚合酶链式反应、酶联免疫吸附法分别检测血清lncRNAMEG3、EZH2水平。采用Spearman相关分析法进行AIS患者血清lncRNAMEG3、EZH2表达水平与美国国立卫生研究院卒中量表(NIHSS)评分之间的相关性分析;采用多因素Logistic回归分析AIS患者合并神经功能致残性损伤的影响因素,并绘制受试者工作特征(ROC)曲线分析血清lncRNA MEG3、EZH2水平对AIS患者合并神经功能致残性损伤的诊断价值。结果脑卒中组患者血清lncRNA MEG3、EZH2表达水平均高于对照组(t=11.817、11.542,P<0.05)。Spearman相关分析显示,AIS患者血清lncRNA MEG3、EZH2水平与NIHSS评分均呈正相关(r=0.540、0.603,P<0.01)。致残性损伤组体质量指数、吸烟史占比、甘油三酯、总胆固醇、同型半胱氨酸、发病-到院时间(ODT)、lncRNAMEG3、EZH2水平均高于非致残性损伤组(t/χ2=2.103、5.050、9.121、5.585、2.276、5.448、4.638、4.682,P<0.05)。多因素Logistic回归分析显示,甘油三酯、总胆固醇、lncRNA MEG3、EZH2以及ODT均是AIS患者合并神经功能致残性损伤的影响因素(OR=4.853、4.277、2.674、3.052、3.901,P<0.05)。lncRNA MEG3、EZH2联合诊断AIS患者合并神经功能致残性损伤的曲线下面积(AUC)大于lncRNAMEG3以及EZH2单独诊断的AUC(Z=2.626、2.954,P<0.01),敏感度、特异度分别为94.74%、82.15%。结论AIS患者血清lncRNA MEG3、EZH2水平均上升,与AIS患者神经功能损伤程度均正相关,可用作AIS患者合并神经功能致残性损伤的诊断指标,且联合诊断效果更好。

Objective To investigate the expression levels of long non-coding RNA(lncRNA)maternally expressed gene 3(MEG3)and enhancer of Zeste homolog 2(EZH2)in serum of patients with acute ischemic stroke(AIS)and the relationship with neurological function damage.Methods A total of 92 AIS patients admitted to Yan'an People's Hospital from January 2021 to November 2022 were collected as the stroke group,and 92 healthy individuals undergoing physical examinations were selected as the control group.According to the National Institutes of Health Stroke Scale(NIHSS)score,patients in the stroke group were divided into the disabled injury group(19 cases)and non-disabled injury group(73 cases).Serum levels of lncRNA MEG3 and EZH2 were detected by real-time quantitative polymerase chain reaction and enzyme-linked immunosorbent assay.Spearman correlation analysis was applied to analyze the correlation between serum expression levels of lncRNA MEG3,EZH2,and NIHSS scores in AIS patients.Logistic regression analysis was applied to identify risk factors for AIS patients complicated with neurological function disabled injury,and receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum lncRNA MEG3 and EZH2 levels in AIS patients complicated with neurological function disabled injury.Results The serum expression levels of lncRNA MEG3 and EZH2 in the stroke group were significantly higher than those in the control group(t=11.817,11.542;P<0.05).Spearman correlation analysis showed that the serum levels of lncRNA MEG3 and EZH2 in AIS patients were positively correlated with the NIHSS score(r=0.540,0.603;P<0.01).Body mass index,proportion of patients with smoking history,triglycerides,total cholesterol,homocysteine,onset�to-door time(ODT),and levels of lncRNA MEG and EZH2 in the disabled injury group were higher than those in the non-disabled injury group(t/χ2=2.103,5.050,9.121,5.585,2.276,5.448,4.638,4.682;P<0.05).Multivariate logistic regression analysis showed that triglycerides,total cholesterol,lncRNA MEG3,EZH2,and prolonged ODT were influencing factors for AIS patients with neurological function disabled injury(OR=4.853,4.277,2.674,3.052,3.901;P<0.05).The area under the curve(AUC)for the combined diagnosis by lncRNA MEG3 and EZH2 in AIS patients with neurological function disabled injury was higher than the AUC for the diagnosis by lncRNA MEG3 or EZH2 alone(Z=2.626,2.954;P<0.05),with sensitivity and specificity of 94.74%and 82.15%,respectively.Conclusion Serum levels of lncRNA MEG3 and EZH2 increased in AIS patients,and are positively correlated with the severity of neurological function damage.They can be used as diagnostic indicators for AIS patients with neurological function disabled injury,and the combined diagnosis effect is better.