老年腔隙性脑梗死患者血清微小RNA-377和微小RNA-137水平及临床意义  

Serum levels of miR-377 and miR-137 in elderly patients with lacunar infarction and their clinical significance

作　　者：张梦云 王维维[1] 胡晓英[1] 刘智芬 高春燕[1] Zhang Mengyun;Wang Weiwei;Hu Xiaoying;Liu Zhifen;Gao Chunyan(First Department of Geriatrics,Harison International Peace Hospital,Hengshui 053000,Hebei Province,China)

机构地区：[1]哈励逊国际和平医院老年病一科,衡水053000

出　　处：《中华老年心脑血管病杂志》2024年第4期422-426,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：衡水市科技计划项目(2021014085Z)。

摘　　要：目的分析老年腔隙性脑梗死(LI)患者血清微小RNA(miR)-377、miR-137水平及临床意义。方法选择2021年2月至2022年12月哈励逊国际和平医院收治的老年LI患者248例作为LI组,另选择同期来我院体检的健康者110例作为健康组;根据美国国立卫生研究院卒中量表(NIHSS)评分将老年LI患者248例分为神经缺损组60例(≥2分)和无神经缺损组188例(<2分)。检测血清miR-377、miR-137水平;用Pearson相关性分析和Spearman相关性分析;logistic回归分析老年LI患者神经缺损影响因素;ROC曲线评估血清miR-377、miR-137水平对老年LI及神经缺损诊断的预测价值。结果LI组血清miR-377、miR-137水平低于健康组(P<0.01)。miR-377和miR-137联合评估老年LI的曲线下面积(AUC)为0.782(95%CI:0.735~0.824),高于二者单一检测(P<0.01)。神经缺损组脑动脉硬化、血红蛋白降低、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)1、IL-6、IL-17、C反应蛋白(CRP)、改良的Rankin量表(mRS)评分高于无神经缺损组(P<0.05,P<0.01),血清miR-377、miR-137水平低于无神经缺损组(0.61±0.25 vs 0.89±0.28,0.61±0.24 vs 0.85±0.27,P<0.01)。血清miR-377与miR-137水平呈正相关(P<0.01);血清miR-377、miR-137水平与TNF-α、IL-6、CRP、mRS评分均呈负相关(P<0.01)。miR-377、miR-137、TNF-α、IL-6、CRP是老年LI患者神经缺损的影响因素(P<0.01)。miR-377、miR-137联合评估老年LI患者神经缺损的AUC为0.812(95%CI:0.758~0.859),高于二者单一检测(P<0.05,P<0.01)。结论血清miR-377、miR-137水平在老年LI及其神经缺损患者血清中表达较低,检测其水平具有一定临床预测价值。Objective To analyze the serum levels of miR-377 and miR-137 in elderly patients with lacunar infarction(LI)and their clinical significance.Methods A total of 248 elderly LI patients(LI group)admitted in our hospital from February 2021 to December 2022 were enrolled,and another 110 healthy individuals who took physical examination during the same period were selected as the healthy group.According to their NIHSS score,the patients of the LI group were divided into nerve defect subgroup(score≥2,60 cases)and non-nerve defect subgroup(score<2,188 cases).Serum miR-377 and miR-137 levels were determined in all the subjects.Pearson and Spearman correlation analyses were conducted.Logistic regression analysis was applied to analyze the influencing factors of neurological deficits in the LI group.ROC curve analysis was employed to evaluate the predictive value of serum miR-377 and miR-137 levels in the diagnosis of LI and nerve defect.Results The serum miR-377 and miR-137 levels were significantly lower in elderly LI patients than the healthy individuals(P<0.01).The AUC value of combined detection of miR-377 and miR-137 was 0.782(95%CI:0.735-0.824),which was statistically higher than that of single detection(P<0.01).The patients from the nerve defect subgroup had significantly larger proportion of cerebral arteriosclerosis,more obviously decreased hemoglobin,lower levels of TNF-α,IL-1,IL-6,IL-17 and CRP,and increased mRS score(P<0.05,P<0.01),but remarkably declined serum levels of miR-377 and miR-137(0.61±0.25 vs 0.89±0.28,0.61±0.24 vs 0.85±0.27,P<0.01)when compared with the patients from the non-nerve defect subgroup.Serum miR-377 and miR-137 levels were positively correlated(P<0.01),and their levels were negatively correlated with the levels of TNF-α,IL-6 and CRP and mRS score(P<0.01).MiR-377,miR-137,TNF-α,IL-6,and CRP were the influencing factors for neurological deficits in elderly LI patients(P<0.01).The AUC value of miR-377 and miR-137 combined together for assessing nerve defect in elderly LI patients was

关 键 词：中风 腔隙性 神经病学表现 循环微RNA 微小RNA-377 微小RNA-137 

分 类 号：R743.33[医药卫生—神经病学与精神病学]