血清miR-122-5p水平与短暂性脑缺血发作病人预后的关系

Relationship between serum miR-122-5p level and prognosis of patients with transient ischemic attack

目的探讨短暂性脑缺血发作(TIA)病人血清miR-122-5p水平变化及其在病人预后评估中的作用。方法选取2013年1月至2016年1月收治的TIA病人150例,采集空腹静脉血检测血清miR-122-5p水平。根据入院ABCD2评分分为高危、中危、低危组。以发病90 d内发生脑梗死或死亡、与症状相关的大动脉狭窄≥50%或心源性栓子需要抗凝治疗为主要结局衡量终点事件。结果150例中,低危组49例,中危组71例,高危组20例。150例中,41例(27.33%)出现终点事件,其中脑梗死10例,死亡1例,大动脉狭窄≥50%有21例,心源性血栓需抗凝治疗9例;其余109例(72.67%)无终点事件情况发生。血清miR-122-5p水平与病人ABCD2评分呈正相关(r=0.784,P<0.05)。发生终点事件TIA病人血清miR-122-5p明显高于无终点事件病人(P<0.05),其中症状相关的大动脉狭窄≥50%病人、脑卒中/死亡病人血清miR-122-5p水平均明显增高(P<0.05),而心源性栓子需抗凝治疗病人血清miR-122-5p水平无明显变化(P>0.05)。多因素logistic回归分析结果显示,血清miR-122-5p水平增高是TIA病人发生终点事件的独立危险因素(P<0.05)。结论TIA病人血清miR-122-5p水平与ABCD2评分呈正相关;血清miR-122-5p水平增高提示TIA病人预后不良。

Objective To explore the change of serum miR-122-5p level in patients with transient ischemic attack(TIA)and its role in the evaluation of patients'prognosis.Methods The serum level of miR-122-5p was detected in 150 patients with TIA who were admitted to our hospital from January 2013 to January 2016 by real-time quantitative PCR.The patients were divided into low,medium and high risk groups according to ABCD2 score at admittion.The primary endpoint included:cerebral infarction or death,symptomrelated large artery stenosis≥50%,or cardiogenic embolus requiring anticoagulation therapy within 90 days of onset.Results Of 150 patients,49 patients were in low-risk group,71 in medium-risk group,and 20 in high-risk group.Of 150 patients,41 patients(27.33%)had an end-point event,including 10 patients with cerebral infarction,1 death,21 with aortic stenosis≥50%,and 9 with cardiogenic thrombosis requiring anticoagulation.The serum miR-122-5p level was significantly positively correlated with the ABCD2 score(r=0.784,P<0.05).The serum level of miR-122-5p in patients with end-point event was significantly higher than that in patients with no end-point event(P<0.05).Multivariate logistic regression analysis showed that increased serum miR-122-5p level was an independent risk factor for the end-point event in TIA patients(P<0.05).Conclusions Serum miR-122-5p level in TIA patients is positively correlated with the ABCD2 score.The increase in serum miR-122-5p level indicates poor prognosis of TIA patients.