ABCD2评分联合血清泛连接蛋白、微小RNA-20b对头晕患者发生缺血性卒中有预测价值

Predictive value of ABCD2 combined with serum Pannexin1 and miR-20b in ischemic stroke in patients with dizziness

目的:探讨年龄、血压、单侧肢体无力和言语障碍、持续时间、糖尿病(ABCD2)评分联合血清泛连接蛋白、微小RNA(miRNA)-20b对头晕患者发生缺血性卒中(IS)的预测价值。方法:收集148例头晕患者,根据是否发生IS分为IS组(109例)和非IS组(39例)。比较分析2组患者一般资料、ABCD2评分和血清泛连接蛋白、miR-20b水平。多因素Logistic回归分析头晕患者发生IS影响因素,采用受试者工作特征(ROC)曲线分析ABCD2评分联合血清泛连接蛋白、miR-20b水平对评估头晕患者发生IS的预测价值。结果:IS组年龄、高血压史比例、ABCD2评分、低密度脂蛋白胆固醇(LDL-C)、泛连接蛋白水平明显高于非IS组,miR-20b水平明显低于非IS组(P均<0.05)。LDL-C升高(OR=2.575,95%CI:1.497~3.353)、ABCD2评分>3分(OR=3.069,95%CI:2.242~5.408)、泛连接蛋白升高(OR=1.089,95%CI:1.018~1.187)为头晕患者发生IS独立影响因素(P均<0.05),miR-20b为独立保护因素(OR=0.351,95%CI:0.220~0.559,P<0.05)。3个指标联合预测头晕患者发生IS的曲线下面积(AUC=0.859,95%CI:0.791~0.926)明显大于ABCD2评分(AUC=0.759,95%CI:0.669~0.849)、泛连接蛋白(AUC=0.656,95%CI:0.554~0.759)、miR-20b(AUC=0.821,95%CI:0.750~0.893)单独预测(P均<0.05)。结论:ABCD2评分和血清泛连接蛋白、miR-20b水平为头晕患者发生IS独立影响因素,3个指标联合对头晕患者IS风险有预测价值。

Objective:To investigate the predictive value of ABCD2 combined with serum pannexin1 and microRNA(miRNA)-20b in the occurrence of ischemic stroke(IS) in patients with dizziness.Methods:A total of 148 patients with dizziness were selected,and divided into IS group(n=109) and non-IS group(n=39) based on whether IS occurred.General data,age,blood pressure,duration of unilateral limb weakness and speech disorder,diabetes(ABCD2) score and serum pannexin and miR-20b levels were compared between the two groups.Multifactorial Logistic regression analysis was conducted to explore independent risk factors for IS in patients with dizziness.The receiver operating characteristic(ROC) curve was drawn to determine the predictive value of ABCD2 combined with serum pannexin1 and miR-20b in the occurrence of IS in patients with dizziness.Results:The age,hypertension history ratio,ABCD2,low-density lipoprotein cholesterol(LDL-C),and pannexin1 levels in the IS group were significantly higher,and the miR-20b level was significantly lower than those in the non-IS group(P<0.05).The elevated LDL-C(OR=2.575,95%CI:1.497-3.353),ABCD2 >3 points(OR=3.069,95%CI:2.242-5.408),elevated pannexin1(OR=1.089,95%CI:1.018-1.187) were independent factors of IS in dizziness patients,and elevated miR-20b(OR=0.351,95%CI:0.220-0.559) was an independent protective factor(P<0.05).The area under the ROC cure(AUC) of combined three indexes in predicting the occurrence of IS in patients with dizziness(AUC=0.859,95%CI:0.791-0.926) was significantly greater than that of the ABCD2 score(AUC=0.759,95%CI:0.669-0.849),pannexin1 score(AUC=0.656,95%CI:0.554-0.759) and miR-20b(AUC=0.821,95%CI:0.750-0.893) used alone(P<0.05).Conclusion ABCD2,Pannesin1,and miR-20b are independent factors influencing the occurrence of IS in dizziness patients.ABCD2 combined with serum pannexin1 and miR-20b are more valuable than a single index for IS risk assessment in dizziness patients.