急性脑梗死患者血清miR-27b和miR-146a表达及其与颈动脉狭窄的相关性分析

Serum miR-27b and miR-146a expression levels and their correlations with carotid artery stenosis in patients with acute cerebral infarction

目的 探讨急性脑梗死(ACI)患者血清miR-27b和miR-146a表达并分析其与颈动脉狭窄的相关性。方法 选取120例ACI患者作为观察组,再选取同期65名健康体检者作为对照组。根据颈动脉狭窄程度将ACI患者分为轻度狭窄组、中度狭窄组、重度狭窄组、完全闭塞组。检测被试者血清miR-27b和miR-146a表达,分析ACI患者血清miR-27b和miR-146a的表达,绘制受试者工作特征(ROC)曲线评估血清miR-27b和miR-146a表达对ACI的诊断价值,再以Pearson相关性分析法分析血清miR-27b和miR-146a表达与颈动脉狭窄的相关性,行多因素Logistic回归分析探讨影响ACI发生的危险因素。结果 观察组患者血清miR-27b表达高于对照组,血清miR-146a表达低于对照组(P<0.01)。血清miR-27b和miR-146a表达对ACI诊断价值的ROC曲线显示,单独检测时血清miR-27b的敏感度最高,miR-146a的特异度最高,两者联合检测时曲线下面积可达0.986。不同颈动脉狭窄程度ACI患者血清miR-27b和miR-146a表达水平不同,其中轻度狭窄组miR-27b表达最低,miR-146a表达最高,而完全闭塞组miR-27b表达最高,miR-146a表达最低,各组间比较,差异均具有统计学意义(P<0.05)。Pearson相关性分析显示,血清miR-27b表达与颈动脉狭窄程度呈正相关(r=0.775,P<0.01),血清miR-146a表达与颈动脉狭窄程度呈负相关(r=-0.622,P<0.01)。多因素Logistic回归分析显示,血清miR-27b、miR-146a表达为ACI患者发生中、重度颈动脉狭窄的影响因素(P<0.01)。结论 ACI患者血清miR-27b表达升高,miR-146a表达降低,可作为临床诊断ACI的潜在指标,且两者联合检测的价值高于单独检测。

Objective To explore serum miR-27b and miR-146a expression levels and their correlations with carotid ar ter y stenosis(CAS) in patients with acute cerebral infarction(ACI).Methods A total of 120 ACI patients were selected as obser vation g roup a nd in the cor responding period 65 healthy exa m i nees a s cont rol g roup.ACI pat ient s were a ssig ned to m ild-,moderate-,severe-stenosis a s well as enti rely-shut g roup accord i ng to t he CAS deg rees.Patient s' ser u m m i R-27b a nd m i R-146a expression levels were detected and analyzed,receiver operating characteristic(ROC) curves plotted to assess the diagnostic values of serum miR-27b and miR-146a expression for the ACI,cor relations of miR-27b and miR-146a expression levels with the CAS analyzed using Pearson cor relation,and risk factors inf luencing the occu r rence of the ACI done using multiva r iate Logistic reg ression a nalysis.Results Serum miR-27b expression level was higher and miR-146a lower in observation than control group(P<0.01).The ROC curve showed that sensitivity of separate miR-27b diagnostic value was the highest,so was the specificity of sepa rate miR-146a,a nd t he a rea u nder t he cu r ve 0.986 when their combination.Serum miR-27b and miR-146a expression levels were d ifferent a mong patients with different degrees of the CAS,miR-27b expression was the lowest and miR-146a the highest in mild g roup,while miR-27b expression the highest a nd miR-146a the lowest in entirely-shut g roup,and differences among all groups were statistically significant(P<0.05).Pearson cor relation analysis showed that serum miR-27b expression was positively cor related with the CAS(r =0.775,P<0.01) and miR-146a negatively(r =-0.622,P<0.01).Multivariate Logistic regression analysis showed that serum miR-27b and miR-146a level were the inf luencing factors of moderate and severe CAS in ACI patients(P<0.05).Conclusion Serum miR-27b expression elevates and miR-146a lowers in ACI patients,which could be used as potential indicators for the clinical diagnosis of the ACI,and their combination has higher value than separate detection.