外周血miR-223和miR-146a水平与急性缺血性脑卒中的相关性研究

Study on the Correlation between Peripheral Blood MiR-223 and MiR-146a Levels and Acute Ischemic Stroke

目的:探究急性缺血性脑卒中外周血miR-223和miR-146a表达水平及其与疾病发生的关系。方法:选择2017年1月至2018年4月在哈尔滨医科大学附属第四医院诊治的76例急性缺血性脑卒中患者作为研究对象(病例组),根据TOAST病因分型,其中大动脉粥样硬化型33例、心源性栓塞型19例、小动脉闭塞型16例、不明原因型8例。60例健康者为对照组。采用RT-PCR法检测受试者外周血miR-223和miR-146a表达水平,NIHSS评分评估急性缺血性脑卒中患者病情严重程度,分析miR-223和miR-146a水平与急性脑卒中的关系。结果:病例组外周血miR-223表达水平显著高于对照组(P<0.05),miR-146a表达水平显著低于对照组(P<0.05);病例组miR-223和miR-146a表达水平在不同病因分型之间差异无统计学意义(P>0.05);病例组miR-233水平与NIHSS评分呈显著正相关关系(r=0.774,P=0.000),miR-146a水平与NIHSS评分呈显著负相关关系(r=0.741,P=0.000);高血压、高血糖、血小板计数、INR和miR-223是急性缺血性脑卒中发生的危险因素,而miR-146a是急性缺血性脑卒中的保护因素。结论:急性缺血性脑卒中患者外周血miR-223高表达,miR-146a低表达,与患者病情严重程度密切相关。

Objective: To investigate the expressions of miR-223 and miR-146 a in peripheral blood of acute ischemic stroke and their relationships with the occurrence of disease. Methods: 76 cases of acute ischemic stroke diagnosed and treated in the Fourth Affiliated Hospital of Harbin Medical University from January2017 to April 2018 were selected as the subjects (case group),according to the TOAST etiological classification,there were 33 cases of main artery atherosis type,19 cases of cardiogenic embolism type,16 cases of small artery occlusion type,and 8 cases of unknown cause type. 60 healthy subjects were as the control group.The expression levels of miR-223 and miR-146 a in peripheral blood were detected by RT-PCR,NIHSS score was used to assess the severity of acute ischemic stroke,the relationships between miR-223 and miR-146 a levels with acute stroke were analyzed. Results: The expression level of miR-223 in peripheral blood of case group was significantly higher than that of control group (P < 0.05),the expression level of miR-146 a was significantly lower than that of the control group (P <0.05);there was no significant difference in the expression levels of miR-223 and miR-146 a between the different etiological subtypes (P >0.05);there was a significant positive correlation between miR-233 level with NIHSS score in case group (r = 0. 774,P = 0.000),there was a significant negative correlation between miR-146 a level with NIHSS score (r = 0.741,P =0.000);hypertension,hyperglycemia,platelet count,INR and miR-223 were risk factors for acute ischemic stroke,miR-146 a is a protective factor for acute ischemic stroke. Conclusion: The miR-223 in peripheral blood of patients with acute ischemic stroke is high expressed,the miR-146 a is low expressed,it is closely related to the severity of the patient’s condition.