血清微小RNA-181c、微小RNA-146a对急性脑梗死病人神经功能缺损及预后的影响

The influence of serum microRNA-181c and microRNA-146a on neurological deficit and prognosis in patients with acute cerebral infarction

目的探究血清微小RNA(miR)-181c、miR-146a对急性脑梗死(ACI)病人神经功能缺损及预后的影响。方法选取南阳市中医院2018年1月至2019年7月ACI病人135例作为研究对象,比较不同美国国立卫生院神经功能缺损评分(NIHSS)、不同预后病人血清miR-181c、miR-146a水平,采用Pearson相关性分析血清miR-181c、miR-146a与NIHSS评分相关性,logistic回归分析血清miR-181c、miR-146a与预后的关系,受试者工作特征(ROC)曲线分析血清miR-181c、miR-146a对预后的预测价值,并采用Kaplan-Meier曲线进行生存分析。结果NIHSS评分≥16分病人血清miR-181c水平(1.63±0.14)高于5~15分(1.52±0.12)、<5分(1.38±0.09)病人,NIHSS评分≥16分病人miR-146a水平(0.54±0.08)低于5~15分(0.67±0.10)、<5分(0.86±0.13)病人(P<0.05);血清miR-181c与NIHSS评分呈正相关,miR-146a与NIHSS评分呈负相关(P<0.05);生存者入院时、入院第3天血清miR-181c水平[(1.45±0.20)、(1.20±0.19)]低于死亡者[(1.68±0.25)、(1.53±0.35)],miR-146a水平[(0.74±0.16)、(0.97±0.23)]高于死亡者[(0.60±0.13)、(0.76±0.15)](P<0.05);血清miR-181c、miR-146a与预后显著相关(P<0.05);预测预后的AUC:入院时第3天miR-146a>入院时第3天miR-181c>入院时miR-146a>入院时miR-181c(P<0.05);miR-181c高危与低危、miR-146a高危与低危者生存曲线比较,差异有统计学意义(P<0.05)。结论ACI病人神经功能缺损与血清miR-181c呈正相关,与血清miR-146a呈负相关,并是预后相关影响因素,均具有较高的预后预测价值。

Objective To explore the effects of serum microRNA-181c and microRNA-146a on neurological deficits and prognosis of patients with acute cerebral infarction(ACI).Methods A total of 135 patients with ACI in Nanyang Hospital of Traditional Chinese Medicine from January 2018 to July 2019 were selected as the research objects,and the levels of serum microRNA-181c and microRNA-146a in patients with different National Institutes of Health Neurological Impairment Score(NIHSS)and different prognosis were compared.Pearson analysis was made of the correlation between the levels of serum microRNA-181c,microRNA-146a and NIHSS score.Logistic regression analysis was made of the association between serum microRNA-181c,microRNA-146a and prognosis,receiver operating characteristics(ROC)curve analysis was made for determining he predictive value of microRNA-181c and microRNA-146a on the prognosis,and the Kaplan-Meier curve was used for survival analysis.Results The serum microRNA-181c level of patients with NIHSS score≥16 points was higher than that of 5-15 points and that less than 5 points[(1.63±0.14)vs.(1.52±0.12)vs.(1.38±0.09)].The serum microRNA-146a level of patients with NIHSS score≥16 points was lower than that of 5-15 points and that less than 5 points[(0.54±0.08)vs.(0.67±0.10)vs.(0.86±0.13);P<0.05].Serum microRNA-181c was positively correlated with NIHSS score,while microRNA-146a was negatively correlated with NIHSS score(P<0.05).The serum microRNA-181c levels[(1.45±0.20),(1.20±0.19)]of the survivors were lower than those of the dead[(1.68±0.25),(1.53±0.35)],the levels of microRNA-146a[(0.74±0.16),(0.97±0.23)]were higher than those of the dead[(0.60±0.13),(0.76±0.15)](P<0.05)at admission and 3 d after admission.Serum microRNA-181c and microRNA-146a levels were significantly correlated with prognosis(P<0.05).Prediction of AUC for prognosis showed that microRNA-146a 3 d after admission>microRNA-181c 3 d after admission>microRNA-146a at admission>microRNA-181c at admission(P<0.05).Differences were statistically significant between microRNA-181c high-risk and low-risk,microRNA-146a high-risk and lowrisk survival curves(P<0.05).Conclusions Neurological deficits in patients with ACI are positively correlated with serum microRNA-181c and negatively correlated with serum microRNA-146a.They are both factors related to prognosis,and both have high prognostic value.