老年急性缺血性脑卒中患者血清miR-150-5p及miR-148b-3p的表达及其临床意义

Expression and clinical significance of serum miR-150-5p and miR-148b-3p in elderly patients with acute ischemic stroke

目的探讨老年急性缺血性脑卒中(AIS)患者血清miR-150-5p及miR-148b-3p的表达水平及其临床意义。方法选取本院收治的178例老年AIS,按照美国国立卫生研究院卒中量表(NIHSS)评分分为:轻度组(52例,NIHSS评分<5分)、中度组(83例,5分≤NIHSS评分≤20分),重度组(43例,NIHSS评分> 20分)。另选择65例健康体检正常者作为对照组。采用实时荧光定量PCR检测各组血清miR-150-5p及miR-148b-3p表达水平。应用ROC曲线分析血清miR-150-5 p及miR-148 b-3 p表达水平对老年AIS诊断的价值。采用多因素logistic回归分析影响老年AIS的危险因素。结果 AIS组血清miR-125b-5p及miR-148b-3p水平明显低于对照组(P <0. 01)。重度组血清miR-125b-5p及miR-148 b-3 p水平均明显低于中度组和轻度组(P <0. 01)。血清miR-150-5 p及miR-148 b-3 p表达水平诊断老年AIS的最佳临界值分别为2. 82、1. 46,两项联合诊断老年AIS的AUC (95%CI)为0. 927 (0. 868~0. 991),其敏感度和特异度为93. 0%和86. 5%。多因素logistic回归分析显示,miR-150-5 p (OR=3. 107,95%CI:2. 194~6. 715)及miR-148 b-3 p (OR=2. 602,95%CI:1. 713~4. 350)低表达是老年AIS发生的独立危险因素。结论血清miR-150-5 p及miR-148 b-3 p表达水平在老年AIS患者中明显降低,是老年AIS发生的独立危险因素,有望作为老年AIS诊断的生物学标志物。

Objective To investigate the expression and clinical significance of serum miR-150-5p and miR-148b-3p in elderly patients with acute ischemic stroke(AIS).Methods A total of 178 elderly patients with AIS admitted to our hospital were enrolled.According to the National Institutes of Health Stroke Scale(NIHSS),they were divided into mild group(n=52,NIHSS score<5),moderate group(n=83,5≤NIHSS score≤20),and severe group(n=43,NIHSS score>20).Sixty-five healthy subjects on physical examination were selected as control group.Real-time PCR was used to determine the expression of serum miR-150-5p and miR-148b-3p in each group.A receiver operating characteristic curve was used to analyze the diagnostic value of serum miR-150-5p and miR-148b-3p levels for elderly AIS patients.Multivariate logistic regression was applied to analyze the risk factors for AIS in the elderly.Results Serum miR-125b-5p and miR-148b-3p levels were significantly lower in the AIS group than in the control group(P<0.01),and they were significantly lower in the severe group than in the moderate and mild groups(P<0.01).The optimal cut-off values of serum miR-150-5p and miR-148b-3p levels for diagnosing AIS in the elderly were 2.82 and 1.46,respectively.The area under the curve for the combination of the two indicators in diagnosis of elderly AIS was 0.927(95%confidence interval[CI]:0.868-0. 991) ,with a sensitivity of 93. 0% and a specificity of 86. 5%. The multivariate logistic regression analysis showed that low expressionof miR-150-5p ( odds ratio [OR]= 3. 107,95%CI: 2. 194-6. 715) and miR-148b-3p ( OR = 2. 602,95%CI: 1. 713-4. 350)were independent risk factors for AIS in the elderly. Conclusions Significantly reduced levels of serum miR-150-5p and miR-148b-3pare independent risk factors for AIS in the elderly,and can be potential biomarkers for the diagnosis of AIS in the elderly.