微小RNA-129-5p和高迁移率族蛋白B1在缺血性脑卒中患者中的表达水平及临床意义

Expression and clinical significance of microRNA-129-5p and high mobility group box 1 in patients with ischemic stroke

目的探讨微小RNA-129-5p(miR-129-5p)和高迁移率族蛋白B1(HMGB1)在缺血性脑卒中(IS)患者中的表达水平及临床意义。方法选取2019年2月至2021年2月河北省第七人民医院收治的94例IS患者为观察组,另选取75例健康体检者为对照组。根据入院时美国国立卫生研究院卒中量表(NIHSS)评分将观察组分为轻度组32例、中度组43例、重度组19例。根据90 d随访的改良Rankin量表评分分为预后良好组65例,预后不良组29例。检测血清miR-129-5p、HMGB1水平,并收集观察组临床资料。采用Pearson相关性分析血清miR-129-5p和HMGB1的关系。多因素Logistic回归分析IS患者预后的影响因素;受试者工作特征(ROC)曲线分析miR-129-5p和HMGB1对IS患者预后的预测价值。结果观察组血清miR-129-5p和HMGB1水平与对照组相比差异有统计学意义(t=3.038、24.863,P<0.05)。观察组血清miR-129-5p水平随神经功能缺损程度的加重而降低,HMGB1水平随之升高(F=83.466、8.423,P<0.05)。Pearson相关性分析显示,观察组血清miR-129-5p和HMGB1水平呈负相关(r=-0.406,P<0.05)。预后良好组和预后不良组的同型半胱氨酸、梗死体积、入院时NIHSS评分、发病到入院时间、miR-129-5p和HMGB1水平间差异具有统计学意义(t=4.636、4.034、11.618、19.522、8.063、6.177,P<0.05)。ROC曲线分析显示,miR-129-5p和HMGB1水平对IS患者预后不良预测价值的曲线下面积分别为0.832、0.859。多因素Logistic回归分析显示,患者入院时NIHSS评分、发病到入院时间、HMGB1、miR-129-5p是IS患者预后不良的影响因素(OR=5.361、4.465、7.245、0.806,P<0.05)。结论IS患者血清miR-129-5p低水平、HMGB1高水平与神经功能缺损程度有关,且对不良预后有一定的预测价值。

Objective To explore the expression and clinical significance of microRNA(miR)-129-5p and high mobility group box 1(HMGB1)in patients with ischemic stroke(IS).Methods Ninety-four patients with IS admitted to Hebei Seventh People's Hospital from February 2019 to February 2021 were selected as the observation group,and 75 healthy individuals were selected as the control group.Based on the National Institutes of Health Stroke Scale(NIHSS)score at admission,the observation group was divided into mild(32 cases),moderate(43 cases),and severe(19 cases)groups.According to the modified Rankin Scale(mRS)score at 90 days of follow-up,the observation group was further divided into good prognosis(65 cases)and poor prognosis(29 cases)groups.Serum levels of miR-129-5p and HMGB1 were measured,and clinical data of the observation group were collected.Pearson correlation analysis was used to assess the relationship between serum miR-129-5p and HMGB1.Multivariate Logistic regression analysis was performed to identify factors influencing the prognosis of IS patients.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the predictive value of miR-129-5p and HMGB1 for the prognosis of IS patients.Results Serum levels of miR-129-5p and HMGB1 in the observation group were significantly different from those in the control group(t=3.038,24.863;P<0.05).Serum miR-129-5p level decreased with the aggravation of severity of neurological deficits,while HMGB1 level increased(F=83.466,8.423;P<0.05).Pearson correlation analysis showed a negative correlation between serum miR-129-5p and HMGB1 in the observation group(r=-0.406,P<0.05).There were statistically significant differences in homocysteine,infarct volume,NIHSS score at admission,onset-to-admission time,miR-129-5p,and HMGB1 levels between the good prognosis and poor prognosis groups(t=4.636,4.034,11.618,19.522,8.063,6.177;P<0.05).ROC curve analysis revealed that the areas under the curve of miR-129-5p and HMGB1 for predicting poor prognosis in IS patients were 0.832 and 0.859,respectively.Multivariate Logistic regression analysis showed that NIHSS score at admission,onset-to-admission time,levels of HMGB1 and miR-129-5p were risk factors for poor prognosis of IS patients(OR=5.361,4.465,7.245,0.806;P<0.05).Conclusion Low serum miR-129-5p level and high HMGB1 level in IS patients are associated with the severity of neurological deficit,and have a predictive value for poor prognosis.