血5′tRF-LysCTT对急性脑梗死早期诊断及病情严重程度判定的价值

The value of the 5′tRF-LysCTT content in the blood for the early diagnosis and evaluation of disease severity in the patients with acute cerebral infarction

目的探究血5′tRF-LysCTT表达水平对急性脑梗死(ACI)患者早期诊断及病情严重程度判定的价值。方法收集2022年10月至2023年10月在哈尔滨医科大学附属第一医院神经内科住院急性脑梗死(ACI)患者为ACI组(n=114),选取同期健康体检者为对照组(n=112)。根据NIHSS评分将ACI患者分为轻型组(NIHSS≤5分,n=66)和中重型组(NIHSS>5分,n=48)。通过实时荧光定量聚合酶链反应(RT-qPCR)技术检测两组血5′tRF-LysCTT水平。应用多因素Logistic回归分析预测ACI患者神经功能缺损程度的危险因素。ROC曲线分析5′tRF-LysCTT对区分轻型、中重型ACI的诊断价值。结果ACI患者血5′tRF-LysCTT水平明显低于对照组(1.34±0.56 vs.3.28±1.01,P<0.001)。与轻型组比较,中重型组血5′tRF-LysCTT表达明显降低(1.65±0.45 vs.0.89±0.36,P<0.001)。与5′tRF-LysCTT相对表达量与ACI神经功能缺损程度呈负相关(P<0.001)。ROC曲线分析5′tRF-LysCTT对区分ACI组与对照组的曲线下面积(AUC值)为0.956(95%CI 0.9317~0.9805),敏感度为94.6%,特异度为84.7%,截断值为2.11;区分ACI轻、中重型的AUC值为0.908(95%CI 0.8543~0.9618),敏感度为93.3%,特异度为80.2%,截断值为1.41,具有较高诊断效率。Logistic回归分析显示,5′tRF-LysCTT是预测神经功能缺损程度的独立危险因素。结论血5′tRF-LysCTT可能成为ACI患者早期诊断及病情严重程度判定的新标志物。

Objective To explore the value of the 5′tRF-LysCTT expression level in the blood for the early diagnosis and evaluation of disease severity in the patients with acute cerebral infarction(ACI).Methods Clinical data of hospitalized ACI patients in the Neurology Department of the First Affiliated Hospital of Harbin Medical University from October 2022 to October 2023 were collected.A total of 114 ACI patients were selected as ACI group,and 112 healthy patients in the same period were selected as the control group.ACI patients were classified into mild group(NIHSS≤5 scores,n=66)and moderate to severe group(NIHSS>5 scores,n=48)based on the national institutes of health stroke scale(NIHSS).The 5′tRF-LysCTT levels in both groups were measured by quantitative real-time polymerase chain reaction(RT-qPCR)technology.Multivariate Logistic regression analysis was applied to predict risk factors for the degree of neurological deficit in ACI patients.ROC curves were used to analyze the diagnostic value of 5′tRF-LysCTT for distinguishing mild ACI from moderate to severe ACI.Results The peripheral blood 5′tRF-LysCTT levels were significantly lower in the ACI group compared with the control group(1.34±0.56 vs.3.28±1.01,P<0.001).The 5′tRF-LysCTT expression in the moderate to severe group was significantly reduced compared with the mild group(0.89±0.36 vs.1.65±0.45,P<0.001).The results of ROC curve analysis showed the AUC value of 5′tRF-LysCTT for distinguishing the ACI group from the control group was 0.956(95%CI 0.9317-0.9805),with a sensitivity of 94.6%,the specificity of 84.7%,the cutoff value of 2.11.At the same time,the AUC value of 5′tRF-LysCTT for distinguishing between mild ACI and moderate to severe ACI was 0.908(95%CI 0.8543-0.9618),with a sensitivity of 93.3%,the specificity of 80.2%,the cutoff value of 1.41,the diagnostic efficiency was high.Logistic regression analysis found 5′tRF-LysCTT was an independent risk factor for predicting the degree of neurological deficit.Conclusions The 5′tRF-LysCTT in the blood of ACI patients may be a new marker for early diagnosis and determination of disease severity.