血清miRNA-27a-3p、miRNA-210水平与ACI患者神经功能改善的关系

The relationship between serum miRNA-27a-3p,miRNA-210 levels and neurological improvement in patients with ACI

目的 探讨急性脑梗死(ACI)患者神经功能与miRNA-572和miRNA-218表达水平的关系。方法选择2020年5月至2020年11月在承德医学院附属医院神经内科就诊的ACI患者82例为ACI组,另选择同时期健康体检者82例作为对照组。采用RT-qPCR检测两组血清中miRNA-27a-3p和miRNA-210水平,全自动生化分析仪检测两组血清中TG、LDL-C和HDL-C的值,美国国立卫生研究院卒中量表(NIHSS)评价患者入院前神经功能缺损情况;改良Rankin量表(mRS量表)评价ACI患者预后情况。应用受试者工作特征曲线(ROC曲线)评估各指标对ACI预后的预测价值,采用多因素Logistic回归分析探讨预后影响因素。结果两组年龄、性别、吸烟、糖尿病、冠心病、高血压、TG、LDL-C和HDL-C比较差异无统计学意义(均P> 0.05);与对照组比较,ACI组血清miRNA-27a-3p显著降低,miRNA-210显著升高(P<0.05);与轻度组比较,中度组和重度组ACI患者miRNA-27a-3p显著降低、miRNA-210显著升高(P<0.05);与中度组比较,重度组ACI患者血清miRNA-27a-3p显著降低、血清miRNA-210显著升高(P<0.05)。预后不良患者血清miRNA-27a-3p低表达率和miRNA-210高表达率显著高于预后良好患者(P <0.05);ROC曲线结果显示,miRNA-27a-3p和miRNA-210的曲线下面积分别为0.892和0.704,预测ACI预后的灵敏度分别为90.82%和74.5%,特异度分别为87.7%和71.6%。预后多因素Logistic回归分析显示,年龄> 65岁[OR及95%CI:2.21 (1.06~3.57)]、miRNA-27a-3p <3.13[OR及95%CI:4.17 (1.86~9.32)]、miRNA-210≥6.91[OR及95%CI:3.82 (1.84~7.94)]为ACI患者预后危险因素(P<0.05)。结论 miRNA-27a-3p表达降低、miRNA-210表达升高与ACI患者的神经功能缺损及预后不良密切相关,两者对ACI患者预后具有较高的预测价值,有望作为急性脑梗死临床有效生物标志物。

Objective To investigate the relationship between serum miRNA-27 a-3 p,miRNA-210 levels and neurological improvement in patients with acute cerebral infarction(ACI).Methods A total of 82 ACI patients who were treated in the Department of Neurology of Affiliated Hospital of Chengde Medical College from May 2020 to November 2020 were selected as the ACI group,and 82 person from the same period of physical examination were selected as the control group.RT-qPCR was used to detect the levels of serum miRNA-27 a-3 p and miRNA-210 in the two groups.The automatic biochemical analyzer was used to detect serum TG,LDL-C and HDL-C in the two groups.The National Institutes of Health Stroke Scale(NIHSS) was used to evaluate the neurological deficits of patients before admission.The prognosis of ACI patients was evaluated by modified Rankin scale(mRS scale).The receiver operating characteristic curve(ROC curve) was used to evaluate the predictive value of each index on the prognosis of ACI,and the multivariate Logistic regression analysis was used to explore the prognostic factors.Results There was no significant difference in age,gender,smoking,diabetes,coronary heart disease,hypertension,TG,LDL-C and HDL-C between the two groups(P>0.05).Compared with the control group,the serum miRNA-27 a-3 p was significantly reduced,and miRNA-210 was significantly increased(P<0.05).Compared with the mild group,miRNA-27 a-3 p and miRNA-210 were reduced in the moderate and severe groups of ACI patients(P<0.05).Compared with the moderate group,the serum miRNA-27 a-3 p of the severe group ACI patients decreased,and the serum miRNA-210 increased(P<0.05).The low expression rate of serum miRNA-27 a-3 p and the high expression rate of miRNA-210 in patients with poor prognosis were significantly higher than those in patients with good prognosis(P<0.05).ROC curve results showed that the areas under the curve of miRNA-27 a-3 p and miRNA-210 were 0.892 and 0.704 respectively,and the sensitivity for predicting the prognosis of ACI was 90.82%and 74.5%,and the specificity was 87.7% and 71.6%,respectively.Multivariate Logistic regression analysis showed that age>65 years [OR and 95%CI:2.21(1.06-3.57)],miRNA-27 a-3 p<3.13[OR and 95%CI:4.17(1.86-9.32)],miRNA-210≥6.91[OR and 95%CI:3.82(1.84-7.94)] were risk factors for the prognosis of ACI patients(P<0.05).Conclusion The decreased expression of miRNA-27 a-3 p and the increased expression of miRNA-210 are closely related to the neurological deficit and poor prognosis of ACI patients.Both have high predictive value for the prognosis of ACI patients and are expected to serve as clinically effective biomarkers for acute cerebral infarction.