缺血性脑卒中梗死患者血浆脑钠肽miR-29b水平与患者短期预后的关系

Relationship Between Plasma Brain Natriuretic Peptide MiR-29b Levels and Short-Term Prognosis in Patients with Ischemic Cerebral Infarction

目的:分析缺血性脑卒中患者血浆脑钠肽(BNP)、miR-29b水平与其短期预后的关系。方法:选择2017年2月至2019年5月发病24h内入院的急性缺血性脑卒中108例作为病例组,将同期体检的40例正常健康人作为对照组,检测血浆BNP、miR-29b水平,比较两组以上指标差异;病例组入院时采用美国国立卫生研究院卒中量表(NIHSS)评估神经功能;根据出院90d改良Rankin量表(mRS)分为预后不良组(mRS>2分,n=39)与预后良好组(mRS≤2分,n=69),分析缺血性脑卒中BNP、miR-29b与患者神经功能及短期预后的关系;多因素Logistic分析筛选患者短期预后相关影响因素。结果:病例组血BNP水平高于对照组,miR-29b表达量低于对照组(P<0.05);预后良好组BNP浓度及NIHSS评分低于预后不良组(P<0.05),miR-29b相对表达量高于预后不良组(P<0.05);年龄、合并高血压、梗死面积、NIHSS评分、BNP及miR-29b均为缺血性脑卒中患者短期预后影响因素(P<0.05);缺血性脑卒中患者BNP与NIHSS评分、mRS评分呈正相关(r=0.467、0.523,P<0.05),miR-29b与NIHSS评分、mRS评分呈负相关(r=-0.375、-0.413,P<0.05)。结论:急性缺血性脑卒中患者伴血浆BNP增高、miR-29b降低特点,且两者异常改变与患者神经功能及短期预后密切相关。

Objective:To analyze the relationship between plasma brain natriuretic peptide(BNP),miR-29b levels and short-term prognosis in patients with ischemic cerebral infarction(ICI).Methods:A total of 108 acute ICI patients who were admitted to the hospital within 24h after onset during the period from February 2017 to May 2019 were enrolled as case group,while 40 normal healthy people who underwent physical examination during the same period were enrolled as control group.The levels of plasma BNP and miR-29b were detected.The differences in the above indexes between the two groups were compared.In case group,nerve function was evaluated by National Institutes of Health Stroke Scale(NIHSS).According to scores of modified Rankin Scale(mRS)at 90d after discharge,they were divided into poor prognosis group(mRS higher 2 points,n=39)and good prognosis group(mRS not higher than 2 points,n=69).The relationship between BNP,miR-29b and nerve function,short-term prognosis was analyzed.The influencing factors of short-term prognosis were screened by multivariate logistic analysis.Results:The level of serum BNP in case group was higher than that in control group,while expression quantity of miR-29b was lower than that in control group(P<0.05).BNP concentration and NIHSS score in good prognosis group were lower than those in poor prognosis group(P<0.05),while relative expression quantity of miR-29b was higher than that in poor prognosis group(P<0.05).Age,hypertension,infarct size,NIHSS score,BNP and miR-29b were all influencing factors of short-term prognosis in ICI patients(P<0.05).BNP was negatively correlated with NIHSS and mRS scores(r=0.467,0.523,P<0.05),while miR-29b was negatively correlated with them(r=-0.375,-0.413,P<0.05).Conclusion:Patients with acute ICI are characterized by increased plasma BNP and decreased miR-29b.And the abnormal changes of the two are closely related to nerve function and short-term prognosis.