老年急性脑梗死患者血清lncRNA XIST和lncRNA SOX2OT水平及其预后价值

Levels and prognostic value of serum lncRNA XIST and lncRNA SOX2OT in elderly patients with acute cerebral infarction

目的分析老年急性脑梗死(ACI)患者血清长链非编码RNA染色体X失活特异转录本(lncRNA XIST)、长链非编码RNA性别决定相关基因簇2重叠转录本(lncRNA SOX2OT)水平变化,并评估其预后价值。方法选取首都医科大学附属北京天坛医院2021年2月-2023年2月收治的154例老年ACI患者为研究对象,采用改良Rankin量表(mRS)评分将患者分为预后良好组(n=111)和预后不良组(n=43),另选取同期健康体检者160人为健康组。采用qRT-PCR分析患者血清lncRNA XIST、lncRNA SOX2OT水平,采用多因素logistic回归分析ACI患者预后不良影响因素;采用Spearman法进行相关性分析。采用受试者工作特征(ROC)曲线分析血清lncRNA XIST、lncRNA SOX2OT水平对ACI患者预后的诊断价值。结果预后不良组lncRNA XIST[(0.47±0.09)vs.(0.61±0.09)vs.(1.01±0.27)]水平低于良好组和健康组,lncRNA SOX2OT[(2.16±0.37)vs.(1.73±0.33)vs.(1.03±0.21)]水平高于良好组和健康组,差异均有统计学意义(F=190.845、367.704,P均<0.001)。预后良好组m RS评分[(1.52±0.37)分vs.(3.79±0.45)分]、NIHSS评分[(3.57±1.11)分vs.(9.72±3.12)分]显著低于预后不良组,差异均有统计学意义(t=32.097、18.092,P均<0.001)。lncRNA XIST与mRS评分、NIHSS评分成负相关(r=-0.503、-0.479,P均<0.001),lncRNA SOX2OT与mRS评分、NIHSS评分成正相关(r=0.525、0.493,P均<0.001)。lncRNA XIST、lncRNA SOX2OT是ACI患者预后的影响因素(P均<0.001)。血清lncRNA XIST、lncRNA SOX2OT联合诊断ACI患者预后的曲线下面积(AUC)为0.920,显著优于单独诊断(Z_(lncRNA XIST vs.联合)=2.123,P=0.034;Z_(lncRNA SOX2OT vs.联合)=2.108,P=0.035),联合诊断的敏感性为90.99%,特异性为79.07%。结论ACI患者血清lncRNA XIST水平下调,lncRNA SOX2OT水平上调,与患者预后密切相关。

Objective To investigate the serum levels of long non⁃coding RNA chromosome X inactivate⁃specific transcripts(lncRNA XIST)and long non⁃coding RNA SOX2 overlapping transcript(lncRNA SOX2OT)in elderly patients with acute cerebral infarction and their prognostic value.Methods From February 2021 to February 2023,154 elderly ACI patients admitted to our hospital were collected as the study subjects.The patients were separated into a good group(n=111)and an adverse group(n=43)using mRS scores.Additionally,160 healthy individuals who underwent physical examination were regarded as the healthy group.qRT⁃PCR was applied to analyze the serum levels of lncRNA XIST and lncRNA SOX2OT in patients;multivariate logistic regression was applied to analyze the factors influencing poor prognosis of patients;Spearman method was applied for correlation analysis.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum lncRNA XIST and lncRNA SOX2OT levels for prognosis.Results The level of lncRNA XIST(0.47±0.09)vs.(0.61±0.09)vs.(1.01±0.27)in the poor prognosis group was lower than that in the good group and healthy group,and the level of lncRNA SOX2OT(2.16±0.37)vs.(1.73±0.33)vs.(1.03±0.21)levels were higher than those in the good group and healthy group,the differences were statistically significant(F=190.845,367.704;all P<0.001).The mRS score(1.52±0.37)vs.(3.79±0.45)and NIHSS score(3.57±1.11)vs.(9.72±3.12)in the good prognosis group were significantly lower than those in the poor prognosis group,the differences were statistically significant(t=32.097,18.092,all P<0.001).lncRNA XIST was negatively correlated with mRS score and NIHSS score(r=-0.503,-0.479;all P<0.001).lncRNA SOX2OT was positively correlated with mRS score and NIHSS score(r=0.525,0.493;all P<0.001).lncRNA XIST and lncRNA SOX2OT were factors affecting patient prognosis(all P<0.05).The area under the curve(AUC)of serum lncRNA XIST and lncRNA SOX2OT combined diagnosis of patient prognosis was 0.920,which was significantly higher than those of individual diagnosis(Z_(lncRNA XIST vs.combination)=2.123,P=0.034;Z_(lncRNA SOX2OT vs.combination)=2.108,P=0.035);the sensitivity of the joint diagnosis was 90.99%,and the specificity was 79.07%.Conclusion The serum lncRNA XIST level was down regulated and lncRNA SOX2OT level was up regulated in ACI patients,and they were closely related to prognosis.