miR-223、miR-200b、miR-199a-5p在缺血性脑卒中患者中的表达及相关性研究

The expression and correlation of miR-223, miR-200b, miR-199a-5p in patients with ischemic stroke

目的 探讨微小RNA(miR)-223、miR-200b、miR-199a-5p在缺血性脑卒中(IS)患者中的表达及相关性。方法 选取2019年3月—2021年3月上海市第六人民医院金山分院IS患者132例为研究对象,根据90 d后改良Rankin量表(mRS)评分分为预后不良组(n=51,mRS评分>2分)和预后良好组(n=81,mRS评分≤2分)。比较两组基线资料,美国国立卫生研究院卒中量表(NIHSS)、mRS评分,血清miR-223、miR-200b、miR-199a-5p,分析上述血清指标与NIHSS、mRS评分的相关性,探讨IS预后不良的影响因素,评价上述血清指标对IS预后的预测价值及不同表达与IS预后的关系。结果 预后不良组血清miR-223、miR-199a-5p表达高于预后良好组,血清miR-200b表达低于预后良好组(P<0.05);miR-223、miR-199a-5p与NIHSS、mRS评分呈正相关,miR-200b与NIHSS、mRS评分呈负相关(P<0.05);将卒中分型、NIHSS评分、血小板计数、发病至治疗时间等其他因素控制后,血清miR-223、miR-200b、miR-199a-5p与IS预后不良(mRS评分)显著相关(P<0.05);血清miR-223、miR-200b、miR-199a-5p联合预测IS预后不良的曲线下面积(AUC)最大,为0.928;miR-223、miR-199a-5p高表达者预后不良发生率高于低表达者,miR-200b低表达者预后不良发生率高于高表达者(P<0.05)。结论 血清miR-223、miR-199a-5p过表达和miR-200b表达缺失均与IS患者神经功能缺损程度及神经功能恶化有关,可为患者预后预测提供参考依据。

Objective To investigate the expression and correlation of microRNA(miR)-223,miR-200b,miR-199a-5p in patients with ischemic stroke(IS).Methods A total of 132 patients with IS in our hospital from March 2019 to March 2021 were selected as the research objects.According to the modified Rankin Scale(mRS) score 90 days later,they were divided into a poor prognosis group(n=51,mRS score>2),Good prognosis group(n=81,mRS score≤2).The baseline data of the two groups,the National Institutes of Health Stroke Scale(NIHSS),mRS score,serum miR-223,miR-200b,miR-199a-5p were compared,and the correlation between the above serum indicators and NIHSS and mRS scores were analyzed,and influencing factors of poor prognosis of IS were explored,the predictive value of the above serum indicators on the prognosis of IS and the relationship between different expressions and the prognosis of IS were evaluated.Results The expression of serum miR-223 and miR-199a-5p in the poor prognosis group was higher than that in the good prognosis group,and the expression of serum miR-200b was lower than that in the good prognosis group(P<0.05);miR-223,miR-199a-5p was positively correlated with NIHSS,mRS The score,and miR-200b was negatively correlated with NIHSS and mRS scores(P<0.05);after controlling for stroke type,NIHSS score,platelet count,time from onset to treatment and other factors,serum miR-223,miR-200b,MiR-199a-5p was significantly correlated with poor prognosis of IS(mRS score)(P<0.05);the area under the curve(AUC) of serum miR-223,miR-200b,miR-199a-5p combined to predict poor prognosis of IS was the largest,It was 0.928;the incidence of poor prognosis was higher in those with high expression of miR-223 and miR-199a-5p than in those with low expression,and the incidence of poor prognosis in those with low expression of miR-200b was higher than that in those with high expression(P<0.05).Conclusion Serum overexpression of miR-223,miR-199a-5p,and loss of miR-200b expression are all related to the degree of neurological deficit and deterioration of neurological function in patients with IS,which can provide a reference for predicting the prognosis of patients.