结合外周血微RNA-181b表达水平探讨急性脑梗死病人侧支循环形成的影响因素  

Exploring the influencing factors of collateral circulation in patients with acute cerebral infarction combined with the expression level of miR-181b in peripheral blood

作　　者：刘相城 付宏 刘春柏 张爽 胡姣月 鲍金 赵增霞 罗翰 符鹏程 刘淑云 LIU Xiangcheng;FU Hong;LIU Chunbai;ZHANG Shuang;HU Jiaoyue;BAO Jin;ZHAO Zengxia;LUO Han;FU Pengcheng;LIU Shuyun(Department of Neurology,Shenzhen Longhua District Central Hospital,Shenzhen,Guangdong 518110,China)

机构地区：[1]深圳市龙华区中心医院神经内科,广东深圳518110

出　　处：《安徽医药》2024年第3期602-607,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的 结合外周血微RNA(miR)-181b表达水平探讨急性脑梗死病人侧支循环形成的影响因素。方法 选择2015年6月至2019年5月在深圳市龙华区中心医院住院治疗的ACI病人175例,采用计算机产生随机数按3∶1的比例将纳入病人分为训练集(129例)和测试集(46例),其中129例训练集病人根据侧支循环形成情况分为两组,其中侧支循环良好组病人90例,侧支循环不良组病人39例,采用定量逆转录PCR(RT-qPCR)检测血清miR-181b表达水平,采用Spearman相关法分析ACI病人血清miR-181b表达与侧支循环形成的相关性,采用logistic回归法分析ACI病人侧支循环形成不良的影响因素,并建立预测模型。结果 侧支循环良好组病人血清miR-181b表达1.92±0.19显著高于侧支循环形成不良组1.48±0.26(P<0.05),Spearman相关性分析结果表明,血清miR-181b表达与侧支循环形成呈显著正相关关系(r=0.77,P<0.001)。logistic回归分析结果表明高血压病史高血压史、血同型半胱氨酸(Hcy)、后循环病变均为ACI病人侧支循环形成不良的独立危险因素(P<0.05);miR-181b表达水平和脑血管狭窄程度为侧支循环形成不良的保护因素(P<0.05)。基于侧支循环形成不良的影响因素构建预测模型:预测值=EXP[0.491-1.914(高血压史)-1.409(Hcy)+2.145(miR-181b相对表达量)-1.286(后循环病变)+0.594(脑血管狭窄程度)]/1+EXP[0.491-1.914(高血压史)-1.409(Hcy)+2.145(miR-181b相对表达量)-1.286(后循环病变)-0.594(脑血管狭窄)]。结论侧支循环良好ACI病人外周血血清miR-181b表达水平较高,脑血管狭窄程度轻和高水平miR-181b为侧支循环形成不良的保护因素,而高血压史、Hcy、后循环病变均为ACI病人侧支循环形成不良的独立危险因素。Objective To explore the influencing factors of collateral circulation formation in patients with acute cerebral infarction(ACI) combined with the expression level of MicroRNA(miR)-181b in peripheral blood.Methods One hundred and seventy-five ACI patients hospitalized in Shenzhen Longhua Central Hospital from June 2015 to May 2019 were selected and randomly assigned into training set(129 cases) and test set(46 cases) by computer according to the ratio of 3:1.Among them,129 patients in training set were assigned into two groups according to the formation of collateral circulation,including 90 patients in good collateral circulation group and 39 patients in poor collateral circulation group.The expression level of serum miR-181b was detected by real-time fluorescence quantitative PCR,the correlation between the expression of serum miR-181b and the formation of collateral circulation in ACI patients was analyzed by Spearman correlation method,and the influencing factors of adverse collateral circulation in ACI patients were analyzed by logistic regression method,and a prediction model was established.Results The expression of miR-181b in good collateral circulation group(1.92±0.19) was significantly higher than that in poor collateral circulation group(1.48±0.26).Spearman correlation analysis showed that serum miR-181b expression was significantly positively correlated with the formation of collateral circulation(r=0.77,P<0.001).Logistic regression analysis indicated that the history of hypertension,Homocysteine(Hcy) and posterior circulation lesions were independent risk factors for poor collateral circulation in ACI patients(P<0.05),while the expression level of miR-181b and the degree of cerebrovascular stenosis were protective factors for the formation of poor collateral circulation(P<0.05).The prediction model was constructed based on the influencing factors of poor collateral circulation,the predictive value was EXP [0.491-1.914(history of hypertension)-1.409(Hcy) + 2.145(relative expression of miR-181b)-1.2

关 键 词：脑梗死 微RNA-181b 侧支循环 血同型半胱氨酸 后循环病变 影响因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]