脑梗死患者血清miR-181c、miR-128b表达水平及其与90天预后的相关性

Serum levels of miR-181c and miR-128b in patients with cerebral infarction and their correlation with 90-day prognosis

目的探讨脑梗死患者血清微小RNA(miRNA)miR-181c、miR-128b表达水平及其与90天预后的相关性,为miRNA在脑梗死诊断和治疗上提供参考意义。方法选取128例脑梗死患者以及同期108例健康体检者作为研究对象,分别作为研究组和对照组。比较两组研究对象的miR-181c和miR-128b表达水平,并分析miR-181c、miR-128b表达水平与疾病严重程度的相关性以及脑梗死相关危险因素;根据90天随访的预后情况分为预后良好组和预后不良组,并对影响90天预后的相关因素进行单因素和Logistic回归分析,探讨影响疾病发生及预后的独立影响因素。结果研究组吸烟、高血脂、高血压、糖尿病以及心房颤动比例明显高于对照组(P<0.05),研究组患者miR-181c、miR-128b表达水平显著高于对照组,差异具有统计学意义(P<0.05),Logistic回归分析结果显示糖尿病、miR-181c、miR-128b表达水平是脑梗死的独立危险因素(P<0.05);Spearman相关性分析显示急性脑梗死患者病情严重程度与血清miR-181c和miR-128b水平呈正相关(r=0.867,P=0.005;r=0.885,P=0.002);预后不良组患者发生高血压、糖尿病、心房颤动的比例和入院时NIHSS评分以及血清miR-181c、miR-128b水平均显著高于预后良好组(P<0.05),Logistic回归分析结果显示入院时NIHSS评分及血清miR-181c、miR-128b水平均与脑梗死患者90天预后存在密切相关性(P<0.05)。结论脑梗死患者血清miR-181c、miR-128b表达水平显著高于健康人群,糖尿病、miR-181c、miR-128b表达水平是脑梗死的危险因素(P<0.05),miR-181c、miR-128b表达水平与患者脑梗死严重程度存在显著正相关,且两者表达水平以及NIHSS评分均与急性脑梗死患者90天预后存在密切联系。

Aim To investigate the expression of serum microRNA (miRNA) miR-181c and miR-128b in patients with cerebral infarction and its correlation with 90-day prognosis,and provide reference for the diagnosis and treatment of cerebral infarction.Methods 128 patients with cerebral infarction admitted to our hospital from January 2015 to June 2018 and 108 healthy subjects in the same period were selected as study subjects and control groups.The expression levels of miR-181c and miR-128b were compared between the two groups,and the correlation between miR-181c,miR-128b expression levels and disease severity,as well as risk factors associated with cerebral infarction were analyzed.According to the prognosis of 90 days follow-up,the good prognosis group and the poor prognosis group were classified,and the factors affecting the prognosis of 90 d were analyzed by single factor and logistic regression analysis to explore the independent influencing factors affecting the occurrence and prognosis of the disease.Results The smoking,hyperlipidemia,hypertension,diabetes and atrial fibrillation rate in the study group were significantly higher than those in the control group (P<0.05),and the expression levels of miR-181c and miR-128b in the study group were significantly higher than those in the control group (P<0.05).Logistic regression analysis showed that the diabetes and expression levels of miR-181c and miR-128b were independent risk factors for cerebral infarction (P<0.05);Spearman correlation analysis showed that the severity of acute cerebral infarction was positively correlated with serum miR-181c and miR-128b levels (r=0.867,P=0.005;r=0.885,P=0.002);The incidence of hypertension,diabetes,atrial fibrillation,NIHSS score at admission,and serum miR-181c and miR-128b levels were significantly higher in patients with poor prognosis than those with good prognosis (P<0.05).Conclusion Logistic regression analysis showed that NIHSS score and serum miR-181c and miR-128b levels were significantly correlated with the 90-day prognosis of patients with acute cerebral infarction.