血清血管内皮生长因子和miR-126与脑微出血的相关性  

Correlation between serum vascular endothelial growth factor,miR-126 and cerebral microbleeds

作　　者：郭霞[1] 贾璐 宋瑞琦 武俊平[1] 王楠[1] 肖庆博 吴丽娥[1] 雍雯 Guo Xia;Jia Lu;Song Ruiqi;Wu Junping;Wang Nan;Xiao Qingbo;Wu Li'e;Yong Wen(The First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014010,China)

机构地区：[1]内蒙古科技大学包头医学院第一附属医院,包头014010

出　　处：《国际脑血管病杂志》2021年第4期265-271,共7页International Journal of Cerebrovascular Diseases

基　　金：内蒙古自治区自然科学基金(2018LH08072);包头医学院科学研究基金(BYJJ-YF-2018014,BYJJ-QM-2018012)。

摘　　要：目的:探讨血清血管内皮生长因子(vascular endothelial growth factor,VEGF)及外周血微RNA-126(microRNA-126,miR-126)与脑微出血(cerebral microbleeds,CMBs)数量和分布的关系。方法:连续纳入2019年6月至2020年6月期间包头医学院第一附属医院神经内科收治的非急性缺血性脑血管病患者。收集患者临床资料,并进行3.0 T MRI检查,应用磁敏感加权成像检测CMBs。采用酶联免疫吸附法检测血清VEGF浓度,采用荧光定量聚合酶链反应对miR-126进行定量检测。应用多变量logistic回归分析确定CMBs的独立影响因素,应用多元线性回归分析确定血清VEGF浓度和外周血miR-126与CBMs数量的相关性。应用受试者工作特征(receiver operating characteristic,ROC)曲线评价血清VEGF浓度和外周血miR-126相对表达量对CMBs的预测价值。结果:共纳入193例非急性缺血性脑血管病患者,非CMBs组110例(57.0%),单纯脑叶CMBs组20例(10.4%),非单纯脑叶CMBs组63例(32.6%)。3组间比较显示,年龄可能是单纯脑叶CMBs的危险因素,VEGF较高、胱抑素C水平较高、外周血miR-126相对表达量较低、高血压以及既往卒中或短暂性脑缺血发作史可能是非单纯脑叶CMBs的危险因素。多变量logistic回归分析显示,血清VEGF浓度较高是非单纯脑叶CMBs的独立危险因素(优势比1.186,95%置信区间1.035~1.358;P=0.014),而miR-126相对表达量较高是非单纯脑叶CMBs的独立保护因素(优势比0.154,95%置信区间0~0.269;P=0.026)。多元线性回归分析显示,血清VEGF浓度较高(r=0.848,P<0.001)和miR-126相对表达量较低(r=-0.043,P=0.035)可显著增加CMBs数量。ROC曲线分析显示,血清VEGF预测非单纯CMBs的曲线下面积为0.803(95%置信区间0.741~0.865),最佳截断值为120.55 ng/L,敏感性为70.7%,特异性为75.5%。结论:在非急性缺血性脑血管病患者中,血清VEGF和外周血miR-126相对表达量与CMBs数量及其分布存在显著相关性,血清VEGF可作为预测非单纯脑叶CMBObjective To investigate the relationship between serum vascular endothelial growth factor(VEGF),peripheral blood microRNA-126(miR-126)and the number and distribution of cerebral microbleeds(CMBs).Methods Consecutive patients with non-acute ischemic cerebrovascular disease admitted to the Department of Neurology,the First Affiliated Hospital of Baotou Medical College from June 2019 to June 2020 were enrolled.The clinical data were collected,3.0 T MRI examination was performed,and susceptibility-weighted imaging was used to detect CMBs.The serum VEGF concentration was detected by enzyme-linked immunosorbent assay,and miR-126 was detected by fluorescence quantitative polymerase chain reaction.Multivariate logistic regression analysis was used to determine the independent influencing factors of CMBs.Multiple linear regression analysis was used to determine the correlation between serum VEGF concentration,miR-126 in peripheral blood and the number of CBMs.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum VEGF concentration and relative expression of miR-126 in peripheral blood for CMBs.Results A total of 193 patients with non-acute ischemic cerebrovascular disease were enrolled,including 110 patients(57.0%)in the non-CMBs group,20(10.4%)in the strictly lobar CMBs group and 63 patients(32.6%)in non-strictly lobar CMBs group.The comparison among the three groups showed that age might be a risk factor for strictly lobar CMBs,while higher VEGF,higher cystatin C level,lower relative expression of miR-126 in peripheral blood,hypertension and previous stroke or transient ischemic attack might be the risk factors for non-strictly lobar CMBs.Multivariate logistic regression analysis showed that higher serum VEGF concentration was an independent risk factor for non-strictly lobar CMBs(odds ratio 1.186,95%confidence interval 1.035-1.358;P=0.014),while the higher relative expression of miR-126 was an independent protective factor for non-strictly lobar CMBs(odds ratio 0.154,95%confide

关 键 词：脑出血 血管内皮生长因子 微RNAS 脑缺血 磁共振成像 生物标志物 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]