血清miR-26a、miR-130a与老年急性脑梗死患者PI3K/Akt信号通路和预后的关系研究

Study on the Relationship between Serum miR-26a,miR-130a and PI3K/Akt Signaling Pathway and Prognosis in Elderly Patients with Acute Cerebral Infarction

目的:研究血清mi R-26a、mi R-130a与老年急性脑梗死(ACI)患者磷酸酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)信号通路和预后的关系。方法:选取2020年3月-2022年10月我院收治的98例老年ACI患者作为研究组,同期选取60例于本院体检健康的老年人作为对照组。采用实时荧光定量聚合酶链式反应(qRT-PCR)检测血清mi R-26a、mi R-130a表达水平,蛋白免疫印迹法检测外周血单个核细胞中PI3K、Akt蛋白表达;采用Pearson相关性分析mi R-26a、mi R-130a表达水平与PI3K、Akt蛋白表达的相关性。患者治疗后行1个月随访,根据改良Rankin量表(m RS)评分分为预后良好组(n=55例,m RS评分≤2分)和预后不良组(n=43例,评分>2分)。收集患者的一般资料,采用Logistic回归模型分析老年ACI患者预后的影响因素。结果:研究组血清mi R-26a表达水平高于对照组,mi R-130a表达水平低于对照组(P<0.05)。研究组PI3K蛋白表达量低于对照组,Akt蛋白表达量高于对照组(P<0.05)。Pearson相关性分析显示,mi R-26a表达水平与PI3K蛋白表达量呈负相关、与Akt蛋白表达量呈正相关,mi R-130a表达水平与PI3K蛋白表达量呈正相关、与Akt蛋白表达量呈负相关(P<0.05)。预后良好组与预后不良组在年龄、房颤占比、入院时美国国立卫生研究院卒中量表(NIHSS)评分、血糖及血清mi R-26a、mi R-130a表达水平方面比较具有统计学意义(P<0.05)。Logistic回归分析显示,年龄偏大、入院时NIHSS评分偏高、血糖偏高及血清mi R-26a表达水平升高为老年ACI患者预后不良的危险因素,mi R-130a表达水平升高为其保护因素(P<0.05)。结论:老年ACI患者血清mi R-26a表达水平升高、mi R-130a表达水平下降,与PI3K/Akt信号通路密切相关,是老年ACI患者预后的影响因素。

Objective:To study the relationship between serum miR-26a,miR-130a and phosphoinositol 3-kinase/protein kinase B(PI3K/Akt)signaling pathway and prognosis in elderly patients with acute cerebral infarction(ACI).Methods:98 elderly patients with ACI who were admitted to our hospital from March 2020 to October 2022 were selected as the study group,at the same time,60 elderly people who were physically healthy in our hospital were selected as the control group.Real-time quantitative fluorescent polymerase chain reaction(qRT-PCR)was used to detect the serum miR-26a and miR-130a expression levels,and PI3K and Akt protein expressions in peripheral blood mononuclear cells were detected by western blotting.Pearson correlation was used to analyze the correlation between the miR-26a,miR-130a expression levels and the PI3K,Akt protein expressions.Patients were followed up for 1 month after treatment,and they were divided into good prognosis group(n=55 cases,mRS score≤2 scores)and poor prognosis group(n=43 cases,score>2 scores)according to the modified Rankin Scale(mRS)score.General data of patients were collected,and Logistic regression model was used to analyze the influencing factors of the prognosis of elderly patients with ACI.Results:The serum miR-26a expression level in the study group was higher than that in the control group,while the miR-130a expression level was lower than that in the control group(P<0.05).The PI3K protein expression in the study group was lower than that in the control group,while the Akt protein expression was higher than that in the control group(P<0.05).Pearson correlation analysis showed that the miR-26a expression level was negatively correlated with the PI3K protein expression and positively correlated with the Akt protein expression.The miR-130a expression level was positively correlated with the PI3K protein expression and negatively correlated with the Akt protein expression(P<0.05).There were statistically significant differences between the good prognosis group and the poor prognosis group in age,atrial fibrillation proportion,National Institutes of Health Stroke Scale(NIHSS)score at admission,blood glucose and serum miR-26a and miR-130a expression levels(P<0.05).Logistic regression analysis showed that older age,high NIHSS score at admission,high blood glucose and elevated serum miR-26a expression level were risk factors for poor prognosis in elderly patients with ACI,and elevated miR-130a expression level was the protective factor(P<0.05).Conclusion:The elevated serum miR-26a expression level and decreased miR-130a expression level in elderly patients with ACI are closely related to the PI3K/Akt signaling pathway,which are influencing factors of the prognosis of elderly patients with ACI.