急性脑卒中患者血清PTX3、miR-199a的水平变化及临床意义

Changes and clinical significance of serum PTX3 and miR-199a in patients with acute stroke

目的探讨急性脑卒中患者血清正五聚蛋白3(PTX3)、微小RNA-199a(miR-199a)的表达,分析二者与患者神经功能的关系及其对疾病的辅助诊断价值。方法选取2018年1月到2019年12月期间在我院接受治疗的急性脑卒中患者83例作为研究组,根据美国国立卫生研究院卒中量表(NIHSS)评分将患者分为轻度组(26例)、中度组(30例)、重度组(27例)。另选取同期在我院进行体检的志愿者40例作为对照组。检测所有研究对象血清中PTX3、miR-199a、中枢神经特异蛋白(S100-β)、神经元特异性烯醇化酶(NSE)的水平。结果研究组患者的血清PTX3、S100-β、NSE水平高于对照组,血清miR-199a水平低于对照组(P<0.05);重度组患者的血清PTX3、S100-β、NSE水平以及NIHSS评分高于中度组和轻度组,血清miR-199a水平低于中度组和轻度组(P<0.05),中度组患者的血清PTX3、S100-β、NSE水平以及NIHSS评分高于轻度组,血清miR-199a水平低于轻度组(P<0.05);经Pearson分析显示,急性脑卒中患者血清PTX3与S100-β、NSE、NIHSS评分均呈正相关(P<0.05),血清miR-199a与S100-β、NSE、NIHSS评分均呈负相关(P<0.05);ROC分析显示,血清PTX3、miR-199a对急性脑卒中均有一定的诊断价值,曲线下面积分别为0.864(95%CI 0.799~0.928)、0.807(95%CI 0.704~0.910),二者联合可进一步提高对急性脑卒中的诊断价值。结论急性脑卒中患者血清PTX3呈高表达,miR-199a呈低表达,且二者的表达均与患者的神经功能密切相关,二者对疾病均有一定辅助诊断价值。

Objective To investigate the expression of serum pentraxin 3(PTX3)and microRNA-199a(miR-199a)in patients with acute stroke,and to further analyze the relationship between PTX3 and miR-199a and the neurological function of the patients and their value in the diagnosis of the disease.Methods 83 patients with acute stroke who were treated in our hospital from January 2018 to December 2019 were selected as the study group.According to National Institute of Health stroke scale(NIHSS)score,the patients were divided into mild group(26 cases),moderate group(30 cases)and severe group(27 cases).Another 40 volunteers who had physical examination in our hospital at the same time were selected as the control group.Serum levels of PTX3,miR-199a,soluble protein-100β(S100-β),and neuron-specific enolase(NSE)in all subjects were detected.Results The levels of PTX3,S100-βand NSE in the study group were higher than those in the control group,and the levels of miR-199a in the study group were lower than those in the control group(P<0.05);The levels of PTX3,S100-β,NSE,NIHSS and miR-199a in severe group were higher than those in moderate group and mild group(P<0.05),and the levels of PTX3,S100-β,NSE and NIHSS in the moderate group were higher than those in the mild group,and the level of miR-199a was lower than that in the mild group(P<0.05);Pearson analysis showed that PTX3 was positively correlated with S100-β,NSE and NIHSS scores in patients with acute stroke(P<0.05),and miR-199a was negatively correlated with S100-β,NSE and NIHSS scores(P<0.05);ROC analysis showed that serum PTX3 and miR-199a had certain diagnostic value for acute stroke.The area under the curve was 0.864(95%CI 0.799~0.928)and 0.807(95%CI 5:0.704~0.910),respectively.The combination of the two could further improve the diagnostic value for acute stroke.Conclusion Serum PTX3 is highly expressed and miR-199a is lowly expressed in patients with acute stroke,and the expression of both is closely related to the patient’s nerve function.Both of them have a certain value of diagnosis.