急性脑梗死患者血清miR-151a-3p和miR-210的表达及其与炎性因子的关系

Expression of serum miR-151a-3p and miR-210 in patients with acute cerebral infarction and their relationship with inflammatory factors

目的分析急性脑梗死(ACI)患者血清miR-151a-3p和miR-210的表达及其与炎性因子的关系,并分析其临床意义。方法选择2015年3月—2018年2月在新疆医科大学附属中医医院诊治的ACI患者160例作为观察组,患者脑梗死体积<5 cm^3者79例为轻度组,5～15 cm^3者35例为中度组,> 15 cm^3者46例为重度组。另选同期在医院接受体检的健康志愿者160例作为健康对照组。对比观察组与健康对照组、不同梗死体积患者血清miR-151a-3p、miR-210以及白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白介素-10 (IL-10)和白介素-17 (IL-17)水平,采用Pearson法分析miR-151a-3p和miR-210的表达与炎性因子的关系,并用受试者工作特征(ROC)曲线分析miR-151a-3p和miR-210对ACI的诊断价值。结果观察组血清miR-151a-3p、IL-1β、TNF-α、IL-10及IL-17水平均明显高于健康对照组,miR-210水平明显低于健康对照组(t=4. 339、6. 240、46. 930、30. 605、56. 776、17. 789,均P=0. 000)。重度组和中度组miR-151a-3p、IL-1β、TNF-α、IL-10及IL-17水平均明显高于轻度组,且重度组又高于中度组,而miR-210水平明显低于轻度组,且重度组又低于中度组(F=3. 068、3. 147、5. 048、9. 784、7. 239、5. 213,P=0. 002、0. 003、0. 000、0. 000、0. 000、0. 000)。Pearson相关性分析发现,miR-151a-3p与IL-1β、TNF-α、IL-10及IL-17呈正相关(r=0. 571、0. 597、0.627、0. 582,P均<0. 01),miR-210与IL-1β、TNF-α、IL-10及IL-17呈负相关(r=-0. 640、-0. 614、-0. 665、-0. 597,P均<0. 01)。根据ROC曲线分析,miR-210联合miR-151a-3p诊断ACI的曲线下面积为0. 826,灵敏度为0. 805,特异度为0. 782,约登指数为0. 587。结论ACI患者的血清miR-151a-3p表达较高,miR-210表达较低,二者与炎性因子的关系密切,可将其纳入到监测ACI患者的指标体系中,且联合检测ACI的价值较好。

Objective To study the expression of serum miR-151a-3p and miR-210 and its relationship with inflammatory factors in patients with acute cerebral infarction （ACI）, and to analyze their clinical significance. Methods One hundred and sixty patients with ACI who were diagnosed and treated in the Affiliated Hospital of Xinjiang Medical University from March 2015 to February 2018 were selected as observation group. Among them, 79 patients with cerebral infarction volume〈5 cm 3 were classified mild group, 35 patients with cerebral infarction volume at 5-15 cm 3 were classified moderate group, 46 patients with cerebral infarction volume〉15 cm 3 were classified severe group. Another 160 healthy volunteers who were received physical examination in our hospital during the same period were selected as control group. The levels of serum miR-151a-3p, miR-210, interleukin-1β （IL-1β）, tumor necrosis factorα （TNF-α）, interleukin 10 （IL-10） and interleukin 17 （IL-17） were compared between the observation group and the control group, and the patients with different infarction volume. The relationship between miR-151a-3p and miR-210 expression and inflammatory factors were analyzed by Pearson method,and the diagnostic value of miR-151a-3p and miR-210 for ACI was analyzed by receiver operating characteristic （ROC） curve. The levels of serum miR-151a-3p, IL-1β, TNF-α, IL-10 and IL-17 in the observation group were significantly higher than those in the control group, and the level of miR-210 was significantly lower than that in the control group （ t =4.339, t =6.240, t =46.930, t =30.605, t =56.776, t =17.789; all P =0.000）. The levels of miR-151a-3p, IL-1β, TNF-α, IL-10 and IL-17 in the severe group and moderate group were significantly higher than those in the mild group, and the severe group was higher than the moderate group, and the miR-210 level was significantly lower than that in the mild group, and the severe group was lower than the moderate group （ F =3.068, F =3.147, F =5.048, F =9.784, F =7.239, F =5.213; P = 0.002 , P =0.003, P =0.000, P =0.000, P =0.000, P =0.000）. According to Pearson correlation analysis, miR-151a-3p was positively correlated with IL-1β, TNF-α, IL-10 and IL-17, and miR-210 was negatively correlated with IL-1β, TNF-α, IL-10 and IL-17 （ r =0.571, r =0.597, r =0.627, r =0.582, r =-0.640, r =-0.614, r =-0.665, r =-0.597; P =0.001, P =0.000, P =0.000, P =0.000, P =0.000, P =0.000, P =0.000, P =0.000）. According to the ROC curve analysis , the sensitivity of miR-210 combined with miR-151a-3p for diagnosing ACI was 0.805, the accuracy was 0.782,the Youden index was 0.587, and the area under the curve was 0.826. Conclusion The expression of miR-151a-3p in patients with ACI were higher, and the expression of miR-210 was lower. They are closely related to inflammatory factors, which can be incorporated into the index system for monitoring patients with ACI, and the value of combined detection of ACI is better.