基于NIHSS评分分析ACI患者YKL-40、Lp-PLA2和miR-151a-3p表达意义及与预后关系

An Analysis of Expressions and Significances of YKL-40,Lp-PLA2 andmiR-151a-3p in ACI Patients Based on NIHSS Score and Their Relationships with Prognosis

目的 探讨基于NIHSS评分分析急性脑梗死(ACI)患者几丁质酶样蛋白-40(YKL-40)、脂蛋白磷脂酶A2(Lp-PLA2)和微小核糖核酸-151a-3p(miR-151a-3p)表达意义及与预后关系。方法 选取2020年12月至2021年12月我院收治的102例ACI患者为研究组,另选同期50例健康体检者为对照组,分别对2组进行YKL-40、Lp-PLA2和miR-151a-3p检测。分析2组YKL-40、Lp-PLA2和miR-151a-3p表达水平;研究组患者根据NIHSS评分分为轻度、中度、重度3组并对比3组YKL-40、Lp-PLA2和miR-151a-3p表达水平;分析ACI患者YKL-40、Lp-PLA2和miR-151a-3p与NIHSS评分相关性及影响预后因素。结果 与对照组比较,研究组患者YKL-40、Lp-PLA2和miR-151a-3p表达水平较高(P<0.001);随着NIHSS评分增高,ACI患者YKL-40、Lp-PLA2和miR-151a-3p表达水平逐渐升高(P<0.001);经过6个月随访,失访8例,剩余94例,预后良好74例(78.72%),预后不良20例(21.28%),与预后良好组比较,预后不良组患者的YKL-40、Lp-PLA2、miR-151a-3p表达水平较高(P<0.001);YKL-40、Lp-PLA2、miR-151a-3p是ACI患者预后不良的独立危险因素(P<0.001)。结论 YKL-40、Lp-PLA2和miR-151a-3p在ACI预后不良患者中呈高表达水平,并随NIHSS评分增高而升高,均与NIHSS评分呈正相关。

Objective To investigate chitinase-like protein-40(YKL-40),lipoprotein phospholipase A2(Lp-PLA2)and microRNA-151a-3p(miR-151a-3p)expression significances and their relationships with prognosis.Methods From December,2020 to December,2021,102 ACI patients admitted to our hospital were selected as the research group,while 50 healthy subjects during the same period were selected as the control group.The two groups were detected for YKL-40,Lp-PLA2 and miR-151a-3p.Expression levels of YKL-40,Lp-PLA2 and miR-151a-3p in these two groups were analyzed;Patients in the study group were divided into the mild,moderate and severe groups according to NIHSS scores,and levels of YKL-40,Lp-PLA2 and miR-151a-3p were compared among groups.The expression level of 151a-3p and the correlation of YKL-40,Lp-PLA2 and miR-151a-3p with NIHSS score and prognostic factors in ACI patients were analyzed.Results Compared with the control group,expression levels of YKL-40,Lp-PLA2 and miR-151a-3p in the study group were higher(P<0.001).The expression level of miR-151a-3p gradually increased(P<0.001);After 6 months of follow-up,8 cases were lost from follow-up.Among the remaining 94 cases,74 cases(78.72%)had good prognosis and 20 cases(21.28%)had poor prognosis.Compared with the good group,expression levels of YKL-40,Lp-PLA2 and miR-151a-3p in the poor prognosis group were higher(P<0.001).YKL-40,Lp-PLA2,and miR-151a-3p were independent risk factors for the poor prognosis in ACI patients(P<0.001).Conclusion YKL-40,Lp-PLA2 and miR-151a-3p are highly expressed in patients with poor prognosis of ACI,and increase with the increase of NIHSS score,which are positively correlated with NIHSS score.