老年急性缺血性脑卒中患者血浆长链非编码RNA X染色体失活特异转录本与侧支循环的关系

Relationship between expression level of LncRNA XIST and formation of collateral circulation in elderly AIS patients

目的探究长链非编码RNA(LncRNA)X染色体失活特异转录本(XIST)在老年急性缺血性脑卒中(AIS)患者血浆中的表达水平及其与侧支循环形成的关系。方法选取老年AIS患者76例,根据侧支循环情况分为侧支循环不良组29例和侧支循环良好组47例,同期选取健康体检者45例为对照组。采用实时荧光定量PCR法检查各组血浆LncRNA XIST、血管内皮生长因子(VEGF)表达,采用ROC曲线评价血浆LncRNA XIST的诊断价值。结果3组血浆LncRNA XIST和VEGF基因表达比较,差异有统计学意义(P=0.000),与对照组比较,侧支循环不良组和侧支循环良好组血浆LncRNA XIST和VEGF基因表达明显升高,且侧支循环良好组较侧支循环不良组升高更明显(P<0.05);血浆LncRNA XIST和VEGF对AIS患者建立良好侧支循环诊断的曲线下面积(AUC)分别为0.782和0.765,临界值分别为1.76和1.81,敏感性分别为70.2%和74.5%,特异性分别为77.0%和74.3%;两者联合诊断AIS患者建立良好侧支循环的AUC为0.852,敏感性和特异性分别为87.2%和71.6%;LncRNA XIST是AIS患者建立侧支循环的保护因素(P<0.05)。结论老年AIS患者血浆LncRNA XIST基因表达明显升高,其可能有助于建立脑内侧支循环,与VEGF联合可更好地判定患者侧支循环形成的情况。

Objective To study the relationship between expression level of LncRNA XIST and formation of collateral circulation in elderly AIS patients.Methods Seventy-six elderly AIS patients were divided into poor collateral circulation group(n=29)and good collateral circulation group(n=47)with 45 healthy people who underwent physical examination in our hospital during the same period served as a control group.The expressions of LncRNA XIST and VEGF were detected by RT-qPCR.The value of plasma LncRNA XIST in predicting collateral circulation in elderly AIS patients was assessed by ROC curve analysis.Results Significant difference was detected in expressions of LncRNA XIST and VEGF gene among the 3 groups(P=0.000).The AUC for plasma LncRNA XIST and VEGF in diagnosis of AIS patients with good collateral circulation was 0.782 and 0.765 respectively with a cutoff value of 1.76 and 1.81 respectively,a sensitivity of 70.2%and 74.5%respectively,and a specificity of 77.0%and 74.3%respectively.The AUC for plasma LncRNA XIST combined with VEGF in diagnosis of AIS patients with good collateral circulation was 0.852 with a sensitivity of 87.2%and a specificity of 71.6%.LncRNA XIST was a protective factor for AIS patients with collateral circulation(P<0.05).Conclusion LncRNA XIST expression level is significantly higher in elderly AIS patients,which may help to establish medial cerebral circulation in elderly AIS patients.LncRNA XIST combined with VEGF can effectively predict the formation of collateral circulation in elderly AIS patients.