出血性脑卒中患者血清miR-4443、TRAF4相对表达量变化的临床意义

Expression levels of serum miR-4443 and TRAF4 in patients with hemorrhagic stroke

目的探讨出血性脑卒中患者血清miR-4443、肿瘤坏死因子受体相关因子(TRAF)4水平变化,并分析其临床意义。方法选取2020年6—12月保定市第一中心医院出血性脑卒中患者77例(脑卒中组)。采用美国国立卫生研究院卒中量表(NIHSS)评分评估患者神经功能缺损程度,根据NIHSS评分将77例患者细分为轻度组(<6分,29例)、中度组(6~13分,27例)、重度组(>13分,21例)。对脑卒中患者随访6个月,根据随访结果将77例患者细分为预后良好组(32例)和预后不良组(45例)。另选取同期健康体检者48名(健康对照组)。采用Pearson相关分析评估miR-4443、TRAF4与NIHSS评分的相关性。采用受试者工作特征(ROC)曲线分析miR-4443、TRAF4单独和联合检测判断出血性脑卒中患者预后的效能。结果与健康对照组比较,脑卒中组miR-4443水平显著降低(P<0.01),TRAF4水平显著升高(P<0.001)。脑卒中组miR4443水平随病情严重程度的升高而降低(P<0.001),TRAF4水平随病情严重程度的升高而升高(P<0.001)。Pearson相关分析结果显示,出血性脑卒中患者NIHSS评分与miR-4443水平呈显著负相关(r=-0.857,P<0.001),与TRAF4水平呈显著正相关(r=0.805,P<0.001)。与预后良好组比较,预后不良组miR-4443水平显著降低(P<0.05),TRAF4水平显著升高(P<0.05)。ROC曲线分析结果显示,miR-4443、TRAF4联合检测判断出血性脑卒中患者预后的曲线下面积(AUC)为0.964,显著高于单项指标检测(AUC分别为0.686、0.790,P<0.05)。结论血清miR-4443、TRAF4水平与出血性脑卒中患者病情严重程度明显相关,对患者预后评估也有一定的价值。

Objective To investigate the changes of serum miR-4443 and tumor necrosis factor receptorassociated factor(TRAF)4 expression levels in patients with hemorrhagic stroke,and to analyze the clinical value.Methods Totally,77 patients admitted to Baoding First Central Hospital from June to December 2020 who were diagnosed as hemorrhagic stroke were enrolled as stroke group.The National Institute of Health Stroke Scale(NIHSS)score was used to evaluate the degree of neurological impairment,the 77 patients were classified into mild group(<6,29 cases),moderate group(6-13,27 cases)and severe group(>13,21 cases).The stroke group was followed up for 6 months,and the good prognosis group(32 cases)and poor prognosis group(45 cases)were established according to the prognosis of patients.Another 48 healthy subjects were enrolled as healthy control group.Pearson correlation coefficient was used to analyze the correlation between miR-4443,TRAF4 levels and the NIHSS score of patients with hemorrhagic stroke.Receiver operating characteristic(ROC)curve was used to analyze the predictive values of miR-4443,TRAF4 and the combined determination for the prognosis of patients with hemorrhagic stroke.Results Compared with healthy control group,the expression level of miR-4443 in stroke group was decreased(P<0.01),and the expression level of TRAF4 was increased(P<0.01).The expression level of miR-4443 in stroke group was decreased with the severity of disease(P<0.001),while the expression level of TRAF4 was increased with the severity of disease(P<0.001).Pearson correlation coefficient analysis showed that NIHSS score was negatively correlated with miR-4443 expression level(r=-0.857,P<0.001),and it was positively correlated with TRAF4 expression level(r=0.805,P<0.001).The expression level of miR-4443 in poor prognosis group was decreased compared with that in good prognosis group(P<0.05),and the expression level of TRAF4 was increased compared with that in good prognosis group(P<0.05).ROC curve analysis showed that the area under curve(AUC)of combined determination(0.964)was increased than those of single determinations(0.686 and 0.790)(P<0.05).Conclusions The development degree of hemorrhagic stroke is related with the expression levels of miR-4443 and TRAF4,which have a value for the prognosis of patients.