外周血miR-25表达与急性脑梗死患者凋亡分子含量及90天预后的相关性  

Correlation between miR-25 expression in peripheral blood and apoptotic molecules contents,and 90 days prognosis of patients with acute cerebral infarction

作　　者：张子英[1] 王新华[2] 席妹景[3] 闫莹莹[1] ZHANG Ziying;WANG Xinhua;XI Meijing;YAN Yingying(Department of Neurorehabilitation,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China;Department of Neurology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China;Emergency Department,People􀆳s Hospital of Puyang,Puyang,Henan 457000,China)

机构地区：[1]郑州大学第五附属医院神经康复科,河南省郑州市450052 [2]郑州大学第五附属医院神经内科,河南省郑州市450052 [3]濮阳市人民医院急诊科,河南省濮阳市457000

出　　处：《中国动脉硬化杂志》2020年第9期773-777,共5页Chinese Journal of Arteriosclerosis

基　　金：河南省医学科技攻关计划联合共建项目(2018020259)。

摘　　要：目的探讨急性脑梗死患者外周血miR-25表达与凋亡分子含量及90天预后的相关性。方法选取急性脑梗死患者162例为急性脑梗死组,体检健康者150例为正常对照组。测定两组外周血miR-25及凋亡分子含半胱氨酸的天冬氨酸蛋白水解酶3(Caspase-3)、B淋巴细胞瘤2基因(Bcl-2)的水平。根据改良Rankin量表(mRS)评分将随访90天的预后情况分为预后良好(mRS评分≤2分)和预后不良(mRS评分>2分)。比较不同预后急性脑梗死患者的临床资料,并进一步行Logistic回归分析,采用受试者工作特征(ROC)曲线评估急性脑梗死患者外周血miR-25表达水平对90天不良预后的预测价值。结果急性脑梗死组患者外周血miR-25、Bcl-2表达水平低于正常对照组,Caspase-3水平高于正常对照组,差异有统计学意义(P<0.05)。相关性分析发现,急性脑梗死患者外周血miR-25表达水平与Bcl-2表达水平呈正相关,与Caspase-3表达水平呈负相关(P<0.05)。急性脑梗死患者随访90天预后良好119例、预后不良43例。不同预后急性脑梗死患者的年龄、发病至治疗时间、入院当天NIHSS评分的差异有统计学意义(P<0.05),其余临床资料差异无统计学意义(P>0.05)。Logistic回归分析发现,年龄较大、入院当天NIHSS评分较高、外周血miR-25表达水平较低是急性脑梗死患者90天预后不良的独立危险因素(P<0.05)。ROC曲线发现,外周血miR-25表达水平预测急性脑梗死患者90天预后不良的截断值为0.635,AUC为0.699(95%CI 0.609~0.789),对应的敏感度、特异度分别为72.09%、65.55%。结论急性脑梗死患者外周血miR-25表达水平降低,可能参与凋亡分子的表达调控。低水平miR-25是急性脑梗死患者预后不良的危险因素,且具有一定早期预测价值。Aim To investigate the correlation between miR-25 expression in peripheral blood and apoptotic molecules contents,and 90 d prognosis of patients with acute cerebral infarction.Methods 162 patients with acute cerebral infarction were selected as the acute cerebral infarction group and 150 healthy people as the normal control group.Peripheral blood levels of miR-25 and apoptotic molecules cysteinyl aspartate specific proteinase-3(Caspase-3),B-cell lymphoma-2(bcl-2)were determined in acute cerebral infarction group and normal control group.According to the score of modified Rankin scale(mRS),prognosis of 90 d follow-up was divided into:good prognosis(mRS score≤2 points)and poor prognosis(mRS score>2 points).The clinical data of acute cerebral infarction patients with different prognosis were compared and further Logistic regression analysis was performed.ROC curve was used to evaluate the predictive value of miR-25 expression level in peripheral blood of acute cerebral infarction patients for adverse prognosis at 90 days.Results Expression levels of miR-25 and bcl-2 in peripheral blood of acute cerebral infarction group were lower than those in normal control group,levels of Caspase-3 were higher than those in normal control group(P<0.05).Correlation analysis found that the expression level of miR-25 in peripheral blood of acute cerebral infarction patients was positively correlated with the expression level of bcl-2,negatively correlated with expression level of Caspase-3(P<0.05).Patients with acute cerebral infarction were followed up for 90 days,including 119 patients with good prognosis,43 patients with poor prognosis.The differences in age,onset treatment time and NIHSS score on the day of admission in acute cerebral infarction patients with different prognosis were statistically significant(P<0.05),while the differences in other clinical data were not statistically significant(P>0.05).Logistic regression analysis found that:older age,higher NIHSS score on the day of admission,low expression level of miR-25 i

关 键 词：急性脑梗死 miR-25 凋亡分子 90天预后 

分 类 号：R5[医药卫生—内科学]