脑梗死患者血清miR-181c、miR-21水平与颈动脉狭窄及其不良预后的相关性预测

Relationship between serum miR-181c,miR-21 levels and carotid artery stenosis in patients with cerebral infarction and prediction of poor prognosis

目的探讨脑梗死患者血清miR-181c、miR-21水平与颈动脉狭窄的关系及对预后不良的相关性预测。方法纳入2015年1月~2019年6月在辽阳市中心医院诊断为脑梗死的患者120例为研究对象,行前瞻性研究。120例患者中颈动脉狭窄患者58例(轻度狭窄患者24例,中度狭窄患者22例,重度狭窄患者12例),设为颈动脉狭窄组,非颈动脉狭窄患者患者62例,设为非颈动脉狭窄组,比较两组患者的一般资料、miR-181c、miR-21水平之间的差异。纳入患者行Rankin量表评分后,分为预后良好组(76例)与预后不良组(44例),比较两组患者的一般资料、miR-181c、miR-21水平,并分析预后不良患者的危险因素。结果颈动脉狭窄组与非颈动脉狭窄组患者的性别、年龄以及体重指数之间比较差异无统计学意义(P>0.05),颈动脉狭窄组患者的糖尿病、高血压以及高脂血症患者的比例显著高于非颈动脉狭窄组(P<0.05);不同颈动脉狭窄程度患者的性别、年龄、体重指数、高血压及高脂血症之间比较差异无统计学意义(P>0.05),随着患者的颈动脉狭窄情况的加重,患者的糖尿病发病情况显著升高(P<0.05);颈动脉狭窄组患者的miR-181c、miR-21水平显著高于非颈动脉狭窄组(P<0.05);不同颈动脉狭窄患者的miR-181c、miR-21水平比较差异有统计学意义(P<0.05),随着患者的颈动脉狭窄程度的升高,患者的miR-181c、miR-21水平显著升高(P<0.05);预后良好组患者的miR-181c、miR-21水平显著低于预后不良组(P<0.05);预后不良组患者的糖尿病、高血压、高脂血症发生率以及NIHSS评分显著高于预后良好组(P<0.05);通过多因素分析,糖尿病、高血压、高脂血症、NIHSS、miR-181c、miR-21均是造成患者预后不良的独立危险因素(P<0.05)。结论随着脑梗死颈动脉狭窄情况的加重,局部病灶部位的炎性水平显著升高,血清miR-181c、miR-21水平显著升高。

Objective To study the relationship between serum miR-181c,miR-21 levels and carotid artery stenosis in patients with cerebral infarction,and to predict the poor prognosis.Methods In this study,120 patients with cerebral infarction diagnosed from January 2015 to June 2019 were selected as the research objects,58 patients with carotid artery stenosis,including 24 patients with mild stenosis,22 patients with moderate stenosis,and 12 patients with severe stenosis.The differences of general information,miR-181c and miR-21 levels between carotid stenosis group and non carotid artery stenosis group were compared,and the prognosis was analyzed Risk factors of good patients.Results There was no significant difference in gender,age and body mass index between carotid stenosis group and non carotid stenosis group(P>0.05).The proportion of patients with diabetes mellitus,hypertension and hyperlipidemia in carotid stenosis group were significantly higher than those in non carotid stenosis group(P<0.05).There was no significant difference in gender,age,body mass index,hypertension and hyperlipidemia in patients with narrow degree(P>0.05).With the aggravation of carotid artery stenosis,the incidence of diabetes mellitus increased significantly;the levels of miR-181c and miR-21 in patients with carotid stenosis were significantly higher than those in patients without carotid artery stenosis The levels of miR-181c and miR-21 in patients with different carotid stenosis were statistically significant(P<0.05),and the levels of miR-181c and miR-21 were significantly increased with the increase of carotid artery stenosis;the levels of miR-181c(t=6.003,P<0.05)and miR-21(t=6.677,P<0.05)in patients with good prognosis were significantly lower than those in patients with poor prognosis The incidence of urinary disease,hypertension,hyperlipidemia and NIHSS score were significantly higher than those in the good prognosis group;through multivariate analysis,diabetes,hypertension,hyperlipidemia,NIHSS,miR-181c,miR-21 were independent risk factors of poor prognosis.Conclusion The serum levels of miR-181c and miR-21 increased significantly with the increase of carotid artery stenosis.