血清miR-15a-5p、FOXO1表达与急性脑梗死静脉溶栓治疗后预后的相关性分析

Correlation analysis of serum miR-15a-5p and FOXO1 expression with prognosis of acute cerebral infarction after intravenous thrombolytic therapy

目的检测miR-15a-5p与叉头转录因子(FOXO1)在静脉溶栓治疗急性脑梗死(ACI)患者血清中的表达情况,并分析其对ACI患者静脉溶栓治疗后预后不良的预测价值。方法将2019年8月至2020年8月就诊于该院并行静脉溶栓治疗的ACI患者135例纳入研究,根据患者溶栓治疗后90 d内改良Rankin量表(mRS)评分分为预后良好组与预后不良组。比较预后良好组与预后不良组临床资料以及miR-15a-5p、FOXO1 mRNA水平的差异,分析影响ACI患者静脉溶栓治疗后预后不良的危险因素,血清miR-15a-5p与FOXO1 mRNA水平对ACI患者预后不良的预测价值,以及ACI患者血清miR-15a-5p与FOXO1 mRNA水平的相关性。结果与预后良好组相比,预后不良组静脉溶栓后24 h内美国国立卫生研究院卒中量表(NIHSS)评分与治疗5 d后NIHSS评分差值(ΔNIHSS评分)、血清FOXO1 mRNA水平降低(P<0.05),发病至溶栓时间、血清miR-15a-5p升高(P<0.05);Logistic回归分析显示,ΔNIHSS评分低于7.57分,发病至溶栓时间高于3.57 h,血清miR-15a-5p水平高于1.44,血清FOXO1 mRNA水平低于0.82均为ACI患者静脉溶栓治疗后预后不良的危险因素;血清miR-15a-5p、FOXO1 mRNA水平预测ACI患者溶栓治疗后预后不良的受试者工作特征(ROC)曲线下面积(AUC)分别为0.825、0.843,ACI患者血清miR-15a-5p与FOXO1 mRNA水平呈负相关(r=-0.847,P<0.05)。结论血清miR-15a-5p、FOXO1 mRNA水平对ACI患者其静脉溶栓治疗后预后不良有一定预测价值。

Objective To detect the expression of miR-15a-5p and forkhead transcription factor(FOXO1)in serum of patients with acute cerebral infarction(ACI)after intravenous thrombolytic therapy,and to analyze the predictive value of serum miR-15a-5p and FOXO1 levels in the prognosis of ACI patients after intravenous thrombolytic therapy.Methods From August 2019 to August 2020,135 ACI patients treated with intravenous thrombolysis admitted to the hospital were included in this study.According to the modified Rankin scale(mRS)score within 90 days after intravenous thrombolysis,the patients were grouped into good prognosis group and poor prognosis group.Clinical data and differences of miR-15a-5p and FOXO1 mRNA levels were compared between the good prognosis group and the poor prognosis group,the risk factors affecting the poor prognosis of ACI patients after intravenous thrombolysis,and the predictive value of serum miR-15a-5p and FOXO1 mRNA levels in ACI patients were analyzed.Meanwhile,the correlation between serum miR-15a-5p and FOXO1 mRNA levels in ACI patients was analyzed.Results Compared with the good prognosis group,the difference of National Institutes of Health Stroke Scale(NIHSS)score(ΔNIHSS score)and serum FOXO1 mRNA level in the poor prognosis group decreased(P<0.05),while the time from onset to thrombolysis and serum miR-15a-5p increased(P<0.05).Logistic regression analysis showed thatΔNIHSS score lower than 7.57,time from onset to thrombolysis higher than 3.57 h,serum miR-15a-5p level higher than 1.44,and serum FOXO1 mRNA level lower than 0.82 were risk factors for poor prognosis after intravenous thrombolysis in ACI patients.The area under ROC curve(AUC)of serum miR-15a-5p and FOXO1 mRNA levels predicting poor prognosis in ACI patients after thrombolytic therapy were 0.825 and 0.843,respectively.Besides,serum miR-15a-5p in ACI patients were negatively correlated FOXO1 mRNA(r=-0.847,P<0.05).Conclusion Serum miR-15a-5p and FOXO1 mRNA levels in ACI patients have certain value in predicting poor prognosis after intravenous thrombolysis.