外周血miRNA的表达水平在无症状性颅内动脉狭窄患者5年脑血管事件中的预测价值

Predictive value of microRNAs expression level in peripheral blood in 5-year cerebrovascular events in patients with asymptomatic intracranial artery stenosis

目的探讨外周血miRNA的表达水平在无症状性颅内动脉狭窄(asymptomatic intracranial artery stenosis,AIAS)患者5年脑血管事件中的预测价值。方法回顾性分析2013年10月-2014年6月在本院进行颅多普勒超声(TCD)检查发现的AIAS患者110例的病例资料,并将其纳入观察组,选取同期经TCD检查未发现有颅内动脉狭窄且一般资料与观察组均衡可比的健康者20例作为对照组;比较2组的血清miRNA-223相对表达水平差异;根据观察组患者5年随访期间出现脑血管事件的患者纳入阳性组,未出现的归纳于阴性组;通过ROC曲线分析血清miRNA-223相对表达水平对预测患者预后的效能。结果观察组血清miRNA-223相对表达水平显著低于对照组(P<0.05);阳性组的TG水平高于阴性组(P<0.05),阳性组的miRNA-223相对表达水平低于阴性组(P<0.05);ROC曲线分析及最大约登指数计算出血清miRNA-223表达水平及TG水平的最大AUC面积截断值分别为miRNA-223的截断值为0.56(敏感度=71.50%,特异性=91.60%)、TG的截断值为1.98(敏感度=55.20%,特异性=65.20%)。结论外周血miRNA-223的表达水平对AIAS患者5年脑血管事件的预测具有较高的特异性,在临床中检测AIAS患者外周血miRNA-223的相对表达水平对诊治及预后判断具有一定的指导价值。

Objective To investigate the predictive value of the expression level of microRNAs in peripheral blood in 5-year cerebrovascular events in patients with asymptomatic intracranial artery stenosis. Methods A retrospective analysis was made of 110 cases of AIAS detected by TCD in our hospital from October 2013 to June 2014, and the data were included in the observation group. Twenty healthy persons who had no intracranial artery stenosis detected by TCD in the same period and whose general data were comparable with those of the observation group were selected as the control group. The relative expression level of serum microRNA223 was compared between the two groups. According to the 5-year follow-up of patients in the observation group, patients with cerebrovascular events during the period were included in the positive group, but not in the negative group. The ROC curve was used to analyze the relative expression level of serum microRNA223 in predicting the prognosis of patients. Results The relative expression level of serum microRNA-223 in the observation group was significantly lower than that in the control group(P<0.05), the level of TG in the positive group was higher than that in the negative group(P<0.05), and the relative expression level of microRNA-223 in the positive group was lower than that in the negative group(P<0.05). ROC curve analysis and maximum Yoden index were used to calculate the maximum AUC area cutoff values of serum microRNA-223 expression and TG levels, respectively: the cutoff value of microRNA-223 was 0.56(sensitivity=71.50%, specificity=91.60%) and TG was 1.98(sensitivity=55.20%, specificity=65.20%).Conclusion The expression level of peripheral blood microRNA-223 had high specificity in predicting 5-year cerebrovascular events in AIAS patients. In clinical practice detecting the relative expression level of peripheral blood microRNA-223 in AIAS patients had important guiding value for diagnosis, treatment and prognosis.