血清微小RNA-1和微小RNA-155表达与急性脑梗死患者疾病程度和预后的关系  

Relationship between serum microRNA-1 and microRNA-155 expression and disease severity and prognosis of acute cerebral infarction

作　　者：赵江 徐小辉[1] 何金峰[1] 汪立松 Zhao Jiang;Xu Xiaohui;He Jinfeng;Wang Lisong(Department of Neurology,Taizhou Municipal Hospital,Taizhou 318000,Zhejiang Province,China;Department of Neurology,Wenling People's Hospital,Wenling 317500,Zhejiang Province,China)

机构地区：[1]台州市立医院神经内科,浙江省318000 [2]温岭人民医院神经内科,浙江省317500

出　　处：《中国基层医药》2021年第12期1824-1830,共7页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省中医高科学研究基金项目(2018ZB093)。

摘　　要：目的探讨急性脑梗死(ACI)患者血清微小RNA-1(miR-1)和微小RNA-155(miR-155)的表达与ACI疾病程度及预后的关系。方法选取台州市立医院2018年4月至2019年8月收治的ACI患者173例为研究组,并根据美国国立卫生研究院卒中量表(NIHSS)评分分为轻度组(78例)、中度组(54例)、重度组(41例)三个亚组。同期选取体检健康者180例作为对照组。采用实时荧光定量PCR(qRT-PCR)检测所有受试者血清miR-1和miR-155表达水平。根据90 d内患者改良Rankin量表(mRS)评分将患者分为预后不良与预后良好组。评估血清miR-1和miR-155表达对ACI预后的预测效能以及ACI不良预后的危险因素。结果研究组高血压史[56.65%(98/173)]、收缩压[(134.02±27.35)mmHg]、舒张压[(88.45±9.52)mmHg]、总胆固醇[(3.78±0.82)mmol/L]、低密度脂蛋白胆固醇[(2.08±0.73)mmol/L]、血清miR-1(2.07±0.37)和miR-155(1.56±0.32)表达水平均显著高于对照组[39.44%(71/180)、(119.37±22.14)mmHg、(81.46±14.13)mmHg、(3.59±0.68)mmol/L、(1.74±0.69)mmol/L、(1.01±0.22)、(1.02±0.24)],高密度脂蛋白胆固醇[(1.24±0.22)mmol/L]显著低于对照组[(1.31±0.26)mmol/L],差异均有统计学意义(χ^(2)=10.462,t=5.542、5.429、2.373、4.498、32.865、17.982、2.725,均P<0.05);随着疾病程度的增加,ACI患者血清miR-1、miR-155表达水平逐渐升高(t=10.212、13.050、3.092、7.027、3.983、4.099,均P<0.05);预后不良组高血压史[64.47%(49/76)]显著高于预后良好组[42.27%(41/97)](χ^(2)=8.419,P<0.05),收缩压[(136.51±12.56)mmHg]、舒张压[(89.53±6.65)mmHg]、NIHSS评分[(7.26±0.58)分]、血清miR-1(1.32±0.15)、miR-155(1.21±0.12)表达水平均显著高于预后良好组[42.27%(41/97)、(132.19±9.32)mmHg、(86.34±5.62)mmHg、(6.44±0.62)分、(1.01±0.07)、(0.99±0.05)](t=2.597、3.418、8.880、10.695、4.633,均P<0.05);受试者工作特征曲线(ROC曲线)分析结果表明血清miR-1和miR-155表达预测ACI预后的曲线下面积(AUC)分别为0.814(95%CI:0.745~0Objective To investigate the relationship between serum microRNA-1(miR-1)and microRNA-155(miR-155)expression and disease severity and prognosis of acute cerebral infarction(ACI)in patients.Methods A total of 173 patients with ACI who received treatment in Taizhou Municipal Hospital between April 2018 and August 2019 were included in this study.These patients were divided into mild(n=78),moderate(n=54)and severe(n=41)groups according to the National Institutes of Health Stroke Scale(NIHSS)score.A total of 180 patients who concurrently received physical examination were included in the control group.Serum miR-1 and miR-155 expression was determined in all participants using quantitative reverse transcription-polymerase chain reaction.The included patients were divided into poor prognosis and good prognosis groups according to modified Rankin scale score within 90 days after treatment.The efficacy of serum miR-1 and miR-155 expression in the prediction of ACI prognosis and the risk factors for poor prognosis of ACI were evaluated.Results The history of hypertension,systolic blood pressure,diastolic blood pressure,total cholesterol,low density lipoprotein cholesterol,serum miR-1 and miR-155 expression in the study group were 56.65%(98/173),(134.02±27.35)mmHg,(88.45±9.52)mmHg,(3.78±0.82)mmol/L,(2.08±0.73)mmol/L,(2.07±0.37)and(1.56±0.32),respectively,which were significantly higher than those in the control group[39.44%(71/180),(119.37±22.14)mmHg,(81.46±14.13)mmHg,(3.59±0.68)mmol/L,(1.74±0.69)mmol/L,(1.01±0.22),(1.02±0.24)],high density lipoprotein cholesterol in the study group was significantly lower than that in the control group[(1.24±0.22)mmol/L vs.(1.31±0.26)mmol/L,χ^(2)=10.462,t=5.542,5.429,2.373,4.498,32.865,17.982 and 2.725,all P<0.05].Serum miR-1 and miR-155 expression in patients with ACI gradually increased with the increase of disease severity(t=10.212,13.050,3.092,7.027,3.983 and 4.099,all P<0.05).The proportion of patients having a history of hypertension in the poor prognosis group was si

关 键 词：脑梗死 卒中 核糖核酸酶类 基因表达 高血压 胆固醇 预后 疾病严重程度指数 

分 类 号：R743.33[医药卫生—神经病学与精神病学]