血浆miR-1、RDW水平对高血压并发心房颤动患者发生缺血性脑卒中的诊断价值

The diagnostic value of plasma miR-1 and RDW levels in ischemic stroke in patients with hypertension and atrial fibrillation

目的探讨红细胞分布宽度(RDW)联合microRNA-1(miR-1)对原发性高血压(EH)并发心房颤动(AF)患者发生缺血性脑卒中的早期诊断价值。方法选取2019年3月至2021年3月该院心内科收治的150例EH未并发AF患者作为对照组;EH并发AF的156例患者作为观察组,根据有无发生缺血性脑卒中再分为非脑卒中组和脑卒中组,其中非脑卒中组98例,脑卒中组58例。观察各组患者miR-1与RDW表达水平。结果对照组、非脑卒中组和脑卒中组患者miR-1和RDW水平均呈升高趋势,且任意两组比较,差异均有统计学意义(P<0.05)。采用受试者工作特征(ROC)曲线分析miR-1和RDW对EH并发AF患者发生缺血性脑卒中的诊断价值,发现miR-1的曲线下面积(AUC)为0.614,最佳临界值为0.565,灵敏度为75.40%,特异度为54.70%;RDW的AUC为0.690,最佳临界值为43.35%,灵敏度为64.30%,特异度为66.00%。联合miR-1和RDW检测(AUC=0.734,95%CI:0.621~0.997)高于单项指标检测的诊断效能。结论miR-1与RDW是EH并发AF患者发生缺血性脑卒中的潜在候选标志物,二者联合检测可提高对EH并发AF患者发生缺血性脑卒中的早期诊断效力,具有较高的临床应用价值。

Objective To investigate the early diagnostic value of red blood cell distribution width(RDW)combined with microRNA-1(miR-1)in ischemic stroke in patients with essential hypertension(EH)and atrial fibrillation(AF).Methods From March 2019 to March 2021,150 patients with EH without AF in the Department of Cardiology of the hospital were selected as the control group,and 156 patients with EH and AF were selected as the observation group.According to the occurrence of ischemic stroke or not,it is further divided into non-stroke group and stroke group,among them,there were 98 cases in the non-stroke group and 58 cases in the stroke group.The expression levels of miR-1 and RDW in each group were observed.Results The levels of miR-1 and RDW in the control group,the non-stroke group and the stroke group patients showed an increasing trend,and there were statistically significant differences between any two groups(P<0.05).The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of miR-1 and RDW for ischemic stroke in patients with EH and AF,and it was found that the area under the curve(AUC)of miR-1 was 0.614,and the optimal cutoff value was 0.565,the sensitivity was 75.40%and the specificity was 54.70%.The AUC of RDW was 0.690,the optimal cutoff value was 43.35%,the sensitivity was 64.30%,and the specificity was 66.00%.The diagnostic efficacy of combined miR-1 and RDW detection(AUC=0.734,95%CI:0.621-0.997)was higher than that of single index detection.Conclusion miR-1 and RDW are potential candidate markers for ischemic stroke in patients with EH and AF.The combined detection of the two could improve the early diagnostic efficiency of ischemic stroke in patients with EH and AF,and has high clinical application value.