急性脑梗死患者血清miR-134、miR-451表达水平与脑损伤标志物和预后不良的关系

Relationship between serum miR-134,miR-451 expression levels and brain injury markers and poor prognosis in patients with acute cerebral infarction

目的研究急性脑梗死(ACI)患者血清微小RNA(miR)-134、miR-451表达水平与脑损伤标志物和预后不良的关系。方法选取2019年3月至2022年3月陕西省宝鸡高新医院收治的230例ACI患者作为观察组。另选取同期健康体检志愿者100例作为对照组。比较两组血清miR-134、miR-451表达水平与脑损伤标志物水平,采用Pearson相关分析明确血清miR-134、miR-451表达水平及视锥蛋白样蛋白1(VILIP-1)、神经元特异性烯醇化酶(NSE)水平与ACI患者预后不良的相关性。随访3个月,将所有ACI患者按照改良Rankin量表评分差异分为预后良好组(143例)和预后不良组(87例),采用多因素Logistic回归分析ACI患者预后不良的影响因素,绘制受试者工作特征(ROC)曲线分析血清miR-134、miR-451及二者联合预测ACI患者预后不良的效能。结果观察组血清miR-134、miR-451表达水平及VILIP-1、NSE水平均高于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,血清miR-134、miR-451表达水平与VILIP-1、NSE水平均呈正相关(r=0.692、0.459、0.672、0.493,P<0.05)。预后不良组年龄、入院时美国国立卫生院脑卒中量表(NIHSS)评分、血清miR-134、miR-451表达水平及VILIP-1、NSE水平均高于预后良好组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄升高、入院时NIHSS评分升高、血清miR-134、miR-451表达水平及VILIP-1、NSE水平升高均为ACI患者预后不良的独立危险因素(P<0.05)。ROC曲线分析发现,血清miR-134、miR-451单独预测ACI患者预后不良的ROC曲线下面积分别为0.784、0.802,低于两项联合的0.911。提示血清miR-134、miR-451联合预测ACI患者预后不良的效能优于两项指标单独预测。结论ACI患者血清miR-134、miR-451均呈异常高表达,与脑损伤标志物和预后不良均密切相关。

Objective To investigate the relationship between serum microRNA(miR)-134 and miR-451 expression levels and brain injury markers and poor prognosis in patients with acute cerebral infarction(ACI).Methods A total of 230 ACI patients admitted to Baoji Gaoxin Hospital of Shaanxi Province from March 2019 to March 2022 were selected as observation group.Another 100 healthy volunteers in the same period were selected as control group.The expression levels of serum miR-134 and miR-451 and the levels of brain injury markers were compared between the 2 groups.Pearson correlation analysis was used to determine the correlation between serum miR-134,miR-451 expression levels and visinin like protein 1(VILIP-1),neuron specific enolase(NSE)levels and poor prognosis of ACI patients.After 3 months of follow-up,all ACI patients were divided into good prognosis group(143 cases)and poor prognosis group(87 cases)according to the modified Rankin scale score.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in ACI patients.The receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of serum miR-134,miR-451 and their combination in predicting poor prognosis of ACI patients.Results The serum expression levels of miR-134,miR-451 and VILIP-1,NSE levels in observation group were significantly higher than those in control group(P<0.05).Pearson correlation analysis showed that serum miR-134 and miR-451 expression levels were positively correlated with VILIP-1,NSE levels(r=0.692,0.459,0.672,0.493,P<0.05).The age,National Institutes of Health Stroke Scale(NIHSS)score at admission,serum miR-134,miR-451 expression levels,VILIP-1,NSE levels in poor prognosis group were higher than those in good prognosis group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that increased age,increased NIHSS score at admission,increased serum miR-134,miR-451 expression levels,VILIP-1,NSE levels were independent risk factors for poor prognosis in ACI patients(P<0.05).ROC curve analysis showed that the area under the ROC curve of serum miR-134 and miR-451 for predicting poor prognosis of ACI patients was 0.784 and 0.802 respectively,which was lower than 0.911 of the combination of the two.Conclusion The serum levels of miR-134 and miR-451 are abnormally high in ACI patients,which are closely related to brain injury markers and poor prognosis.