miR-145、miR-210、Lp-PLA2与缺血性脑卒中患者颈动脉狭窄的关联性分析

Association analysis of miR-145,miR-210,Lp-PLA2 and carotid artery stenosis in patients with ischemic stroke

目的 探讨微小RNA-145 (miR-145)、微小RNA-210 (miR-210)、脂蛋白相关磷脂酶A2 (Lp-PLA2)与缺血性脑卒中(IS)患者颈动脉狭窄的关联性。方法 选取东南大学附属中大医院江北院区2019年8月至2022年8月IS患者106例,按照颈动脉超声检查分为狭窄组(存在颈动脉狭窄)、无狭窄组(无颈动脉狭窄)。采集两组一般资料,检测比较两组miR-145、miR-210、Lp-PLA2水平,应用Logistic回归分析观察IS患者颈动脉狭窄的影响因素,并比较不同颈动脉狭窄程度患者miR-145、miR-210、Lp-PLA2水平,分析miR-145、miR-210、Lp-PLA2水平间相关性。结果 狭窄组血清miR-145、miR-210水平低于无狭窄组,血浆LP-PLA2水平高于无狭窄组(P<0.05);Logistic回归分析发现,吸烟史、糖尿病、高血压、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、C反应蛋白、miR-145、miR-210、LpPLA2水平、NIHSS评分均属IS患者颈动脉狭窄的影响因素(P<0.05);血清miR-145、miR-210水平组间比较,重度狭窄患者<中度狭窄患者<轻度狭窄患者,血浆LP-PLA2水平组间比较,重度狭窄患者>中度狭窄患者>轻度狭窄患者(P<0.05);Spearman相关性分析显示,血清miR-145、miR-210水平与患者颈动脉狭窄程度呈负相关,血浆Lp-PLA2水平与患者颈动脉狭窄程度呈正相关(P<0.05);Pearson相关性分析显示,IS颈动脉狭窄患者血清miR-145与miR-210水平呈正相关,与血浆Lp-PLA2水平呈负相关,miR-210水平与血浆Lp-PLA2水平呈负相关(P<0.05)。结论 miR-145、miR-210、Lp-PLA2水平与IS患者颈动脉狭窄发生及狭窄程度有关,可能协同参与了颈动脉狭窄进展过程。

Objective To investigate the association between microRNA-145(miR-145),microRNA-210(miR-210),lipoprotein-associated phospholipase A2(Lp-PLA2)and carotid artery stenosis in patients with ischemic stroke(IS).Methods A total of 106 patients with IS from August 2019 to August 2022 in the Department of Laboratory,Jiangbei Hospital of Zhongda Hospital Affiliated to Southeast University were enrolled and divided into stenosis group(carotid artery stenosis)and no stenosis group(no carotid artery stenosis)according to carotid ultrasound.The general data of two groups were collected,the levels of miR-145,miR-210 and Lp-PLA2 were detected and compared,and the influencing factors of carotid artery stenosis in ischemic stroke patients were observed by Logistic regression analysis.The levels of miR-145,miR-210 and Lp-PLA2 in patients with different degrees of carotid artery stenosis were compared,and the relationship between miR-145,miR-210 and Lp-PLA2 levels were analyzed.Results The serum levels of miR-145 and miR-210 in the stenosis group were lower than those in the stenosis group,and the plasma Lp-PLA2 levels were higher than those in the non-stenosis group(P<0.05);Logistic regression analysis showed that smoking history,diabetes,hypertension,triacylglycerol,total cholesterol,LDL cholesterol,C-reactive protein,miR-145,miR-210,Lp-PLA2 levels,and NIHSS scores were all influencing factors for carotid artery stenosis in patients with IS(P<0.05);Serum miR-145 and miR-210 levels were compared between groups,patients with severe stenosis<patients with moderate stenosis<patients with mild stenosis,and plasma Lp-PLA2 levels were compared between groups,patients with severe stenosis>moderate stenosis>patients with mild stenosis(P<0.05);Spearman correlation analysis showed that serum miR-145 and miR-210 levels were negatively correlated with the degree of carotid artery stenosis,and plasma Lp-PLA2 levels were positively correlated with the degree of carotid artery stenosis(P<0.05);Pearson correlation analysis showed that serum miR-145 was positively correlated with miR-210 levels and negatively correlated with plasma Lp-PLA2 levels and miR-210 levels negatively associated with plasma Lp-PLA2 levels in patients with IS carotid artery stenosis(P<0.05).Conclusion The levels of miR-145,miR-210 and Lp-PLA2 are related to the occurrence and degree of carotid artery stenosis in patients with IS,and may be synergistic in the progression of carotid artery stenosis.