急性脑梗死患者血清中miR-15b表达变化及临床意义

Changes of serum miR-15b expression in patients with acute cerebral infarction and its clinical significance

目的:探讨急性脑梗死患者血清中miR-15b表达变化及临床意义。方法:选取2016年3月至2017年9月,在我院神经内科住院治疗的急性脑梗死患者165例,同期,从体检中心选取健康体检者50例作为对照组,根据美国国立卫生研究院卒中量表(NIHSS)评分将患者分为轻型组(n=72)、中型组(n=69)和重型组(n=24),根据全脑数字减影血管造影(DSA)检查将患者分为侧支循环未完全组(n=67)和侧支循环建立组(n=98),依据影像学检查结果分为小梗死组(n=57)、中梗死组(n=69)和大梗死组(n=39),实时荧光定量PCR术检测血清中miR-15b表达,酶联免疫吸附试验(ELISA法)检测血清中血管内皮生长因子(VEGF)和血管生成素2(Ang-2)浓度。结果:急性脑梗死患者血清中miR-15b相对表达量、VEGF和Ang-2浓度均高于对照组(P<0. 05);侧支循环建立组患者血清中miR-15b相对表达量低于侧支循环未完全组,而VEGF和Ang-2浓度高于侧支循环未完全组(P<0. 05);与轻型组比较,中型组和重型组患者血清中miR-15b相对表达量升高,而VEGF和Ang-2浓度降低,与中型组比较,重型组患者血清中miR-15b相对表达量升高,而VEGF和Ang-2浓度降低,差异均有统计学意义(P<0. 05);与小梗死组比较,中梗死组和大梗死组患者血清中miR-15b相对表达量升高,而VEGF和Ang-2浓度降低(P<0. 05),与中梗死组比较,大梗死组患者血清中miR-15b相对表达量升高,而VEGF和Ang-2浓度降低(P<0. 05)。结论:miR-15b在急性脑梗死患者血清中呈高表达,可能通过靶蛋白VEGF而参与侧支循环建立,且与患者病情严重程度及脑梗死体积呈正相关。

Objective: To investigate the changes of serum miR-15b expression in patients with acute cerebral infarction and its clinical significance. Methods: 165 cases of patients with acute cerebral infarction hospitalized in the Department of Neurology in our hospital were selected from March 2016 to September 2017. In the same period,50 healthy subjects were selected from the physical examination center as the control group. According to the National Institutes of Health Stroke Scale ( NIHSS),patients were divided into light group ( n = 72),medium group ( n = 69) and severe group ( n = 24). According to whole brain digital subtraction angiography ( DSA),patients were divided into incomplete collateral circulation group ( n = 67) and collateral circulation group ( n = 98). According to the result of imaging examination,patients were divided into small infarction group ( n = 57),middle infarction group ( n = 69) and large infarction group ( n = 39). Real-time fluorescence quantitative PCR was used to detect the expression of miR-15b in serum. Enzyme linked immunosorbent assay ( ELISA) was used to detect the serum levels of VEGF and Ang-2. Results: The relative expression of miR- 15b,the concentrations of VEGF and Ang-2 in the serum of patients with acute cerebral infarction were higher than those in the control group ( P<0. 05). The relative expression of miR-15b in collateral circulation group was lower than that in the incomplete collateral circulation group,while the oncentrations of VEGF and Ang-2 were higher than those in the incomplete collateral circulation group ( P<0. 05). Compared with the light group, the relative expressions of miR-15b in the serum in the medium group and severe group were increased,while the concentrations of VEGF and Ang-2 were decreased,compared with the medium group,the relative expression of miR-15b in the serum in the severe group was increased,while the concentrations of VEGF and Ang-2 were decreased,the differences were statistically significant ( P< 0. 05). Compared with the small infarction group,the relative expression levels of miR-15b in the serum of patients in the middle infarction group and the large infarction group were increased,while the concentrations of VEGF and Ang-2 were decreased ( P<0. 05), compared with the middle infarction group,the relative expression level of miR-15b in the serum of patients in the large infarction group was increased,while the concentrations of VEGF and Ang-2 were decreased ( P< 0. 05). Conclusions: miR-15b was highly expressed in the serum of patients with acute cerebral infarction. It was possible to participate in collateral circulation through the target protein VEGF,and it was positively correlated with the severity of the patient's condition and the volume of cerebral infarction.