血清miR-103、sCD40L对急性缺血性脑卒中治疗效果及预后评估的价值  

Relationships between serum miR-103,sCD40L and the therapeutic effect and prognosis of acute isch⁃emic stroke

作　　者：韩旭东 梁志刚[2] 阎志慧 张惠龙[2] HAN Xudong;LIANG Zhigang;YAN Zhihui;ZHANG Huilong(Internal Medicine-Neurology,Yantai Harbor Hospital,Yantai 264012,China)

机构地区：[1]烟台海港医院神经内科,山东烟台264012 [2]烟台毓璜顶医院神经内科 [3]烟台山医院神经内科

出　　处：《山东医药》2022年第10期25-29,共5页Shandong Medical Journal

基　　金：山东省医药卫生科技发展计划项目(2018WS1032)。

摘　　要：目的探讨血清微小核糖核酸-103(miR-103)、可溶性CD40配体(sCD40L)在急性缺血性脑卒中(AIS)治疗效果及预后评估中的价值。方法选择142例AIS患者(AIS组)和70例查体健康者(对照组)。AIS组予常规治疗,根据疗效将患者分为有效组(106例)和无效组(36例),出院后随访3个月,根据改良RANKIN量表(mRS评分)分为预后良好组(99例)和预后不良组(43例)。分别于治疗前、治疗3 d、治疗7 d、治疗14 d,采用RT-qPCR检测血清miR-103,酶联免疫吸附试验检测血清sCD40L。采用Logistic逐步回归分析miR-103、sCD40L与AIS患者预后的关系,采用受试者工作特征(ROC)曲线分析miR-103、sCD40L对AIS疗效判断及预后预测的价值。结果AIS组血清miR-103、sCD40L均高于对照组(P均<0.05)。有效组治疗后血清miR-103、sCD40L先升高后下降(P均<0.05),无效组治疗前后差异无统计学意义(P均>0.05)。有效组治疗7、14 d血清miR-103、sCD40L低于无效组(P均<0.05)。Lo?gistic逐步回归分析结果示NIHSS评分、治疗14 d miR-103、治疗14 d sCD40L是AIS患者预后不良的危险因素(P均<0.05)。治疗7 d miR-103、sCD40L判断AIS疗效的曲线下面积(AUC)为0.756、0.724,miR-103联合sCD40L判断AIS治疗疗效的AUC为0.875,高于治疗7 d miR-103、sCD40L单独判断(P均<0.05)。治疗14 d miR-103联合sCD40L预测AIS患者预后不良的AUC为0.854,二者联合高于治疗14 d miR-103、sCD40L单独判断(AUC分别为0.763、0.732,P均<0.05)。结论miR-103、sCD40L增高与AIS患者疗效差以及预后不良有关,可作为AIS患者治疗效果及预后评估的潜在参考指标。Objective To investigate the relationships between serum micro ribonucleic acid-103(miR-103),solu⁃ble CD40 ligand(sCD40L)and clinical therapeutic effect and neurological prognosis in patients with acute ischemic stroke(AIS).Methods Totally 142 cases of AIS patients(AIS group)and 70 physical examination volunteers(control group)were selected.All AIS patients received conventional AIS treatment.According to the therapeutic effect,the patients were divided into the effective group(106 cases)and ineffective group(36 cases).After discharge,the patients were followed up for 3 months and divided into the good prognosis group(99 cases)and poor prognosis group(43 cases)according to the modified Rankin scale(mRS).The RT-qPCR was used to detect the level of serum miR-103,and enzyme-linked immuno⁃sorbent assay was used to detect the level of serum sCD40L before treatment,at 3,7 and 14 days of treatment,respective⁃ly.The relationships between miR-103 and sCD40L and the prognosis of AIS patients were analyzed by Logistic stepwise regression analysis.The value of miR-103 and sCD40L in judging the therapeutic efficacy of AIS and in predicting the prognosis of patients was analyzed by receiver operating characteristic(ROC)curve.Results Serum miR-103 and sCD40L in the AIS group were higher than those in the control group(both P<0.05).After treatment,serum miR-103 and sCD40L in the effective group increased first and then decreased(both P<0.05),while there were no significant changes in the ineffective group(both P>0.05).The serum miR-103 and sCD40L in the effective group were lower than those in the ineffective group at 7 and 14 days of treatment(both P<0.05).Logistic stepwise regression analysis showed that NI⁃HSS score,miR-103 and SCD40L at 14 days of treatment were risk factors for poor prognosis in AIS patients(all P<0.05).The area under the curve(AUC)of miR-103 and sCD40L for judging the efficacy of AIS treatment at 7 days of treatment was 0.756 and 0.724,respectively(P<0.05);the AUC of miR-103 combined with sCD40L at

关 键 词：急性缺血性脑卒中 微小核糖核酸-103 可溶性CD40配体 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]