急性缺血性脑卒中患者血清miR-433-5p表达水平及其与Hcy及MMP-9的相关性研究

Expression of Serum miR-433-5p and Its Correlation with Hcy and MMP-9 in Patients with Acute Ischemic Stroke

目的探讨急性缺血性脑卒中(acute ischemic stroke,AIS)患者血清微小核糖核酸(micro RNA,miR)-433-5p表达与同型半胱氨酸(homocysteine,Hcy)及基质金属蛋白酶9(matrix metalloproteinase-9,MMP-9)的相关性,为AIS的诊疗提供依据。方法选取2019年1月~2021年3月三亚中心医院收治的106例AIS,采用美国国立卫生研究院卒中量表(NIHSS)评分分为轻度组(n=30,NIHSS评分<5分)、中度组(n=48,5分≤NIHSS评分≤20分)、重度组(n=28,national institute of health stroke scale,NIHSS评分>20分)。另选择60例健康体检正常者作为对照组。采用实时荧光定量PCR检测各组血清miR-433-5p表达水平。应用ROC曲线分析血清miR-433-5p,Hcy及MMP-9水平对AIS诊断的价值,Pearson相关分析AIS患者血清miR-433-5p表达水平与Hcy及MMP-9的相关性。结果AIS组血清miR-433-5p(2.96±0.94),Hcy(19.14±5.30μmol/L)及MMP-9(151.36±29.75μg/L)水平高于对照组(0.81±0.17,5.65±1.13μmol/L,77.93±11.28μg/L),差异均有统计学意义(t=16.718,14.216,10.152,均P<0.001)。重度组血清miR-433-5p(4.36±1.20),Hcy(29.12±6.48μmol/L)及MMP-9(227.15±48.20μg/L)水平均高于中度组(2.80±0.91,18.20±4.86μmol/L,140.83±25.64μg/L)和轻度组(1.83±0.57,11.35±3.24μmol/L,85.27±11.93μg/L),差异均有统计学意义(t=9.847~14.636,均P<0.001)。ROC曲线显示,miR-433-5p诊断AIS的曲线下面积(AUC)最大(0.851,95%CI:0.792~0.908),其敏感度和特异度分别为89.4%,82.0%。相关分析显示,AIS患者血清miR-433-5p表达水平与Hcy及MMP-9均呈正相关(r=0.842,0.714,P<0.01)。结论血清miR-433-5p表达水平在AIS患者中明显升高,且与Hcy及MMP-9水平相关,有望作为AIS诊断的有用标志物。

Objective To investigate the correlation between serum miR-433-5p expression and homocysteine(Hcy)and matrix metalloproteinase-9(MMP-9)in patients with acute ischemic stroke(AIS),so as to provide basis for the diagnosis and treatment of AIS.Methods 106 cases of AIS admitted to Sanya Central Hospital from January 2019 to March 2021 were selected.The national institutes of health stroke scale(NIHSS)score were used to divide the patients into mild group(n=30,NIHSS score<5),moderate group(n=48,5≤NIHSS score≤20),and severe group(n=28,NIHSS score>20).Another 60 healthy subjects were selected as control group.Real-time fluorescent quantitative PCR was used to detect the expression of serum miR-433-5p in each group.The diagnostic value of serum levels of miR-433-5p,Hcy and MMP-9 in AIS patients were analyzed by ROC curve.Pearson correlation analysis of serum levels of miR-433-5p and their correlation with Hcy and MMP-9 in AIS patients.Results The levels of serum miR-433-5p(2.96±0.94),Hcy(19.14±5.30μmol/L)and MMP-9(151.36±29.75μg/L)in AIS group were higher than those in control group(0.81±0.17,5.65±1.13μmol/L,77.93±11.28μg/L),the differences were statistically significant(t=16.718,14.216,10.152,all P<0.001).The levels of serum miR-433-5p(4.36±1.20),Hcy(29.12±6.48μmol/L)and MMP-9(227.15±48.20μg/L)in severe group were higher than those in moderate group(2.80±0.91,18.20±4.86μmol/L,140.83±25.64μg/L)and mild group(1.83±0.57,11.35±3.24μmol/L,85.27±11.93μg/L),the differences were statistically significant(t=9.847~14.636,all P<0.001).ROC curve showed that the area under the curve(AUC)of miR-433-5p in the diagnosis of AIS was the largest(0.851,95%CI:0.792~0.908),with a sensitivity of 89.4%and specificity of 82.0%,respectively.Relevant analysis showed that levels of serum miR-433-5p were positively correlated with Hcy and MMP-9 in patients with AIS(r=0.842,0.714,P<0.01).Conclusion Serum miR-433-5p expression level was significantly increased in AIS patients,and were correlated with Hcy and MMP-9 levels,which is expected to be a useful marker for AIS diagnosis.