RBP、miR-126、Sirt1在急性脑梗死中的表达及与颈动脉粥样硬化斑块稳定性的相关性

Expression of RBP,miR-126,and SIRT1 in acute cerebral infarction and their correlation with carotid atherosclerotic plaque stability

目的研究急性脑梗死患者血清视黄醇结合蛋白(retinol binding protein,RBP)、微小核糖核酸126(microRNA-126,miR-126)、沉默信息调节因子1(silent information regulator1,Sirt1)水平较健康人变化幅度,并分析急性脑梗死患者三个指标水平变化与颈动脉粥样硬化斑块稳定性的相关性。方法选取来我院就诊的急性脑梗死患者140例为病例组,另选同期健康体检者60例为对照组,病例组患者行彩色多普勒超声检查,据超声结果分为稳定斑块组(n=78)和不稳定斑块组(n=62)。收集研究对象的临床资料;酶联免疫吸附试验检测血清RBP、Sirt1表达;实时荧光定量PCR法检测血清miR-126表达;Spearman分析患者血清RBP、miR-126、Sirt1表达与颈动脉粥样硬化斑块稳定性的关系;受试者工作特征曲线分析患者血清RBP、miR-126、Sirt1表达对颈动脉粥样硬化斑块稳定性的预测价值。结果病例组患者血清RBP表达较对照组增加,miR-126、Sirt1表达较对照组降低(P<0.05);不稳定斑块组血清RBP表达较稳定斑块组增加,miR-126、Sirt1表达较稳定斑块组降低(P<0.05);血清RBP表达与颈动脉粥样硬化斑块稳定性存在正相关关系(r=0.423,P<0.05),血清miR-126、Sirt1表达与颈动脉粥样硬化斑块稳定性存在负相关关系(r=-0.514、-0.366,P<0.05);RBP、miR-126、Sirt1及联合预测的AUC为0.746、0.798、0.712、0.892,敏感度为59.7%、75.8%、75.8%、74.2%,特异度为84.6%、70.5%、64.1%、92.3%,三指标联合预测颈动脉粥样硬化斑块稳定性的价值好于单一预测价值。结论急性脑梗死患者血清RBP表达增加,miR-126、Sirt1表达降低,与颈动脉粥样硬化斑块稳定性相关,血清RBP、miR-126、Sirt1对颈动脉粥样硬化斑块稳定性具有较好的预测价值。

Objective To study the changes of serum retinol binding protein(RBP),microRNA-126(miR-126)and silent information regulator1(Sirt1)levels in patients with acute cerebral infarction(ACI)compared with healthy subjects,and to analyze the correlation between the changes of the three indexes and the stability of carotid atherosclerotic plaques in patients with ACI.Methods A total of 140 patients with ACI who presented to our hospital were selected as the case group,and 60 healthy physical examinees during the same period were selected as the control group.Patients in the case group underwent color Doppler ultrasonography and were divided into stable plaque group(n=78)and unstable plaque group(n=62)according to the ultrasound results.Clinical data of subjects were collected.The expression of serum RBP and Sirt1 was detected by enzyme-linked immunosorbent assay,and the expression of serum miR-126 was detected by real-time fluorescence quantitative PCR.Spearman was used to analyze the relationship between the expression of serum RBP,miR-126,Sirt1 and the stability of carotid atherosclerotic plaque.Receiver operating characteristic curve analysis was performed to evaluate the predictive value of serum RBP,miR-126,and Sirt1 expression on the stability of carotid atherosclerotic plaques in patients.Results Compared with control group,the expression of serum RBP in case group was increased,while the expression of miR-126 and Sirt1 was decreased(P<0.05).The expression of serum RBP in unstable plaque group was increased compared with that in stable plaque group,while the expression of miR-126 and Sirt1 was decreased compared with that in stable plaque group(P<0.05).The expression of serum RBP was positively correlated with the stability of carotid atherosclerotic plaque(r=0.423,P<0.05),and the expression of serum miR-126 and Sirt1 was negatively correlated with the stability of carotid atherosclerotic plaque(r=-0.514,-0.366,P<0.05).The AUC of RBP,miR-126,Sirt1 and their combination in prediction was 0.746,0.798,0.712,and 0.892,respectively,with a sensitivity of 59.7%,75.8%,75.8%,74.2%,respectively,and specificity of 84.6%,70.5%,64.1%,and 92.3%,respectively.The combined prediction value of the three indexes was superior to that of the single one.Conclusion The increased expression of serum RBP and the decreased expression of miR-126 and Sirt1 in patients with ACI are correlated with the stability of carotid atherosclerotic plaque.Serum RBP,miR-126 and Sirt1 have good predictive value for the stability of carotid atherosclerotic plaque.