急性脑梗死患者外周血LncRNA-NEAT1,miR-93-5p表达水平及临床意义

Expression Level and Clinical Significance of Peripheral Blood LncRNA-NEAT1 and miR-93-5p in Patients with Acute Cerebral Infarction

目的探究长链非编码RNA核富集转录体1(long non-coding RNA paraspeckle assembly transcript 1,LncRNA-NEAT1)和微小RNA(micro RNA,miR)-93-5p在急性脑梗死(acute cerebral infarction,ACI)患者血清中的表达情况及临床意义。方法选取2020年1月~2022年2月河北北方学院附属第一医院收治的84例急性脑梗死患者作为脑梗死组,收集其临床资料,根据梗死病灶面积分为小面积梗死组、中面积梗死组和大面积梗死组;根据神经功能缺损程度分为轻度组、中度组和重度组;根据预后结局分为生存组和死亡组;同期健康体检者84例为对照组。采用实时荧光定量PCR法检测血清LncRNA-NEAT1和miR-93-5p表达水平;采用受试者工作特征(ROC)曲线分析血清LncRNANEAT1和miR-93-5p表达水平对急性脑梗死患者预后的预测效能。结果与对照组相比,脑梗死组血清LncRNANEAT1(2.46±0.38 vs 1.01±0.20)表达水平显著升高,miR-93-5p(0.42±0.16 vs 1.02±0.22)表达水平显著降低,差异具有统计学意义(t=30.948,33.796,均P<0.05)。血清LncRNA-NEAT1表达水平随梗死病灶面积(2.21±0.36,2.45±0.39,2.75±0.45)和神经功能缺损程度(2.24±0.34,2.46±0.40,2.70±0.45)增加而升高(F=11.434,8.674,均P<0.05),miR-93-5p表达水平(0.68±0.20,0.43±0.17,0.12±0.04)随梗死病灶面积和神经功能缺损程度(0.63±0.19,0.41±0.16,0.21±0.08)增加而降低,差异具有统计学意义(F=79.777,49.316,均P<0.05)。与生存组相比,死亡组血清LncRNA-NEAT1(2.78±0.43 vs 2.39±0.40)表达水平显著升高,miR-93-5p(0.28±0.09 vs 0.45±0.18)表达水平显著降低,差异具有统计学意义(t=3.378,3.550,均P<0.05)。血清LncRNA-NEAT1,miR-93-5p单独及联合预测急性脑梗死患者死亡的曲线下面积(AUC)分别为0.733(95%CI:0.591~0.876),0.784(95%CI:0.669~0.898)和0.849(95%CI:0.752~0.946),敏感度分别为53.3%,73.3%和86.7%,特异度分别为76.8%,75.4%和73.9%。结论LncRNANEAT1与miR-93-5p联合检测对急性脑梗死有一定预后预测价值。

Objective To investigate the expression and clinical significance of long non-coding RNA paraspeckle assembly transcript 1(LncRNA-NEAT1)and microRNA(miR)-93-5p in the serum of patients with acute cerebral infarction.Methods From January 2020 to February 2022,84 patients with acute cerebral infarction(ACI)admitted to the First Affiliated Hospital of Hebei North University were taken as the cerebral infarction group.Their clinical data were collected,and according to the size of the infarction lesions,they were grouped into small infarction group,medium infarction group,and large infarction group.According to the degree of neurological deficit,they were grouped into mild group,moderate group and severe group,and according to prognosis,they were grouped grouped into survival group and death group.Meantime,84 healthy subjects were the control group.The expression levels of serum LncRNA-NEAT1 and miR-93-5p were detected by real-time fluorescent quantitative PCR.Using receiver operating characteristic(ROC)curve to analyze the predictive efficacy of serum LncRNA-NEAT1 and miR-93-5p expression levels on the prognosis of patients with acute cerebral infarction.Results Compared with the control group,the expression level of serum LncRNA-NEAT1(2.46±0.38 vs 1.01±0.20)in the cerebral infarction group was greatly increased,the expression level of miR-93-5p(0.42±0.16 vs 1.02±0.22)was greatly decreased,and the difference was statistically significant(t=30.948,33.796,all P<0.05).The expression level of serum LncRNA-NEAT1 increased with the increases of the infarcted lesion area(2.21±0.36,2.45±0.39,2.75±0.45)and the degree of neurological deficit(2.24±0.34,2.46±0.40,2.70±0.45)(F=11.434,8.674,all P<0.05),while the expression level of miR-93-5p decreased with the increases of the infarct lesion area(0.68±0.20,0.43±0.17,0.12±0.04)and the degree of neurological deficit(0.63±0.19,0.41±0.16,0.21±0.08)(F=79.777,49.316,all P<0.05),the differences were statistically significant,respectively.Compared with the survival group,the expression level of serum LncRNA-NEAT1(2.78±0.43 vs 2.39±0.40)in the death group was greatly increased,the expression level of miR-93-5p(0.28±0.09 vs 0.45±0.18)was greatly decreased,and the difference was statistically significant(t=3.378,3.550,all P<0.05).The area under the curve(AUC)of serum LncRNA-NEAT1,miR-93-5p alone,and their combination to predict death in patients with acute cerebral infarction were 0.733(95%CI:0.591~0.876),0.784(95%CI:0.669~0.898)and 0.849(95%CI:0.752~0.946),respectively.The sensitivity were 53.3%,73.3%and 86.7%,respectively,and the specificity were 76.8%,75.4%and 73.9%,respectively.Conclusion The combined detection of LncRNA-NEAT and miR-93-5p has certain prognostic value in acute cerebral infarction.