血清HIF-1α、mir-210水平与急性脑梗死患者早期神经功能改善的关系

Relationship between levels of serum HIF-1αand mir-210 with improvement of early neurological function in patients with acute cerebral infarction

目的观察血清缺氧诱导因子-1α(HIF-1α)、微小DNA-210(mir-210)水平与急性脑梗死患者早期神经功能改善的关系。方法根据早期(24 h)卒中神经功能量表(NIHSS)评分改善情况,将2019年下半年收治的105例急性脑梗死患者分为早期NIHSS评分改善大于75%组(38例)、改善50%~75%组(46例)、改善小于50%组(21例)。所有研究对象均于治疗前行血清HIF-1α、mir-210水平检测,并于治疗前、治疗后24 h进行NIHSS神经功能测评。采用Pearson秩相关法分析血清HIF-1α、mir-210水平与NIHSS评分之间的相关性。结果改善大于75%组、改善50%~75%组、改善小于50%组在血清HIF-1α、mir-210表达水平上依次降低,差异有统计学意义(P<0.05)。经Pearson秩相关性法分析,血清HIF-1α水平与NIHSS改善值呈负相关(OR=-0.957,P<0.05),血清mir-210水平与NIHSS改善值呈负相关(OR=-0.920,P<0.05)。以血清HIF-1α、mir-210鉴别NIHSS改善分级的曲线位于参考线之上,鉴别NIHSS改善大于75%与NIHSS改善50%~75%、NIHSS改善50%~75%与NIHSS改善小于50%的准确率、灵敏度,特异度均高于80%。结论急性脑梗死患者早期存在明显的血清HIF-1α、mir-210异常高表达,血清HIF-1α、mir-210水平越高,越不利于早期神经功能的改善,且血清HIF-1α、mir-210水平在患者早期神经功能改善预测中具有一定的临床价值。

Objective To observe the relationship between the levels of serum HIF-1αand mir-210 with the improvement of early neurological function in the patients with acute cerebral infarction.Methods According to the improvement situation of NIHSS score in early stage(24 h),105 cases of acute cerebral infarction admitted in the hospital during the second half of 2019 were divided into the group with early stage NIHSS score improvement>75%(38 cases),the NIHSS score improvement 50%-75%group(46 cases)and the NIHSS score improvement<50%group(21 cases).The levels of serum HIF-1αand mir-210 in all study subjects were measured before treatment and the neurological function was detected and evaluated before treatment and at 24 h after treatment.The Pearson rank correlation method was used to analyze the correlation between HIF-1αand mir-210 levels with NIHSS score.Results The expression levels of serum HIF-1αand mir-210 in the improvement>75%,improvement 50%-75%and improvement<50%groups were decreased in turn,and the differences were statistically significant(P<0.05).The Pearson rank correlation analysis indicated that the serum HIF-1αlevel was negatively correlated with the NIHSS improvement(OR=-0.957,P<0.05),and the serum mir-210 level was negatively correlated with the NIHSS improvement value(OR=-0.920,P<0.05).The curve of serum HIF-1αand mir-210 for differentiating the NIHSS improvement grade was above the reference line,the accuracy,sensitivity and specificity of differentiating the NIHSS improvement>75%and NIHSS improvement 50%-75%,and differentiating the NIHSS improvement 50%-75%and NIHSS improvement<50%all were higher than 80%.Conclusion The abnormal high expression levels of HIF-1αand mir-210 exist in early stage of the patients with acute cerebral infarction,the higher theserum HIF-1αand mir-210 levels,the more unfavorable the improvement of early neurological function,moreover serum HIF-1αand mir-210 expression levels have a certain clinical value in the prediction of early neurological function improvement.