急性缺血性脑卒中患者血清miRNA-181c-5p,miRNA-340-5p和miRNA146a水平表达检测的诊断价值研究

Diagnostic Value of miRNA-181c-5p,miRNA-340-5p and miRNA146a Levels in Patients with Acute Ischemic Stroke

目的探究急性缺血性脑卒中(acute ischemic stroke,AIS)患者血清miRNA-181c-5p,miRNA-340-5p和miRNA146a水平表达检测的诊断价值。方法选取西安医学院第一附属医院急诊科2019年5月~2020年3月收治的65例AIS患者为病例组,另选同期50例体检健康者为对照组。比较两组的糖尿病史、高血压史和高血脂史,采用实时灾光定量PCR(quantitative real-time PCR,qRT-PCR)检测miRNA-181c-5p,miRNA-340-5p和miRNA146a的水平。采用美国国立卫生院卒中量表(NIH stroke scale,NIHSS)评估AIS患者的神经功能缺损程度。采用受试者工作特征曲线(receiver operating characteristic,ROC)计算miRNA-181c-5p,miRNA-340-5p和miRNA146a的AIS诊断价值。结果两组的糖尿病史、高血压史和高血脂史比较差异无统计学意义(P>0.05)。相比于对照组,病例组血清中miRNA-181c-5p,miRNA-340-5p和miRNA146a水平均升高,其差异具有统计学意义(t=20.700,25.997,23.629,均P=0.000)。Pearson相关性分析结果显示,血清中miRNA-181c-5p,miRNA-340-5p和miRNA146a水平与NIHSS评分均呈显著正相关,其差异具有统计学意义(r=0.272,P<0.001;r=0.142,P=0.005;r=0.171,P=0.013)。miRNA-181c-5p,miRNA-340-5p和miRNA146a联合检测诊断AIS的灵敏度和特异度分别为71.2%和76.4%,高于三项单独和两两联合检测。结论miRNA-181c-5p,miRNA-340-5p和miRNA146a三者联合检测可进一步提高AIS患者的诊断率,为临床应用提供了可靠的理论基础。

Objective To explore the diagnostic value of detection of serum miRNA-181c-5p,miRNA-340-5p and miRNA146a levels in patients with acute ischemic stroke(AIS).Methods A total of 65 AIS patients admitted to the Department of Emergency,the First Affiliated Hospital of Xi’an Medical University from May 2019 to March 2020 were selected as the case group,and another 50 healthy patients during the same period were selected as the control group.The history of diabetes,hypertension and hyperlipidemia in the two groups were compared.Quantitative real-time PCR(QRT-PCR)was used to detect the levels of miRNA-181c-5p,miRNA-340-5p and miRNA146a.The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the degree of neurological impairment in AIS patients.AIS diagnostic value of miRNA-181c-5p,miRNA-340-5p and miRNA146a was calculated by receiver operating characteristic(ROC)curve.Results There was no statistically significant difference between the two groups in the history of diabetes,hypertension and hyperlipidemia(P>0.05).Compared with the control group,the serum levels of miRNA-181c-5p,miRNA-340-5p and miRNA146a in the case group were significantly increased,and the differences were statistically significant(t=20.700,25.997,23.629,all P=0.000).Pearson correlation analysis showed that serum levels of miRNA-181c-5p,miRNA-340-5p and miRNA146a were significantly positively correlated with NIHSS score,and the differences were statistically significant(r=0.272,P<0.001;r=0.142,P=0.005;r=0.171,P=0.013).The sensitivity and specificity of miRNA-181c-5p,miRNA-340-5p and miRNA146a combined detection for the diagnosis of AIS were 71.2%and 76.4%higher than those of three separate and paired detection.Conclusion Combined detection of miRNA-181c-5p,miRNA-340-5p and miRNA146a can further improve the diagnostic rate of AIS patients,providing a reliable theoretical basis for clinical application.