血清mir-223、HMGB1水平与脑卒中后并发血管性认知功能障碍的关系  

The relationship between serum mir-223 and HMGB1 levels and vascular cognitive impairment after stroke

作　　者：褚丽芳 朱倩 姚洁 马彩云 CHU Lifang;ZHU Qian;YAO Jie;MA Caiyun(Department of Internal Neurology,The People's Hospital of Shijiazhuang,Shijiazhuang,Hebei 050000,China)

机构地区：[1]石家庄市人民医院神经内科,河北石家庄050000

出　　处：《安徽医药》2025年第5期967-972,共6页Anhui Medical and Pharmaceutical Journal

基　　金：石家庄市科学技术研究与发展计划项目(211201313)。

摘　　要：目的探讨血清微RNA-223(mir-223)、血清高迁移率族蛋白B1(HMGB1)水平与脑卒中后并发血管性认知功能障碍(VCI)的关系。方法选取2021年8月至2022年12月石家庄市人民医院就诊的100例脑卒中病人作为研究对象,根据病人是否并发VCI分为发生VCI组31例和未发生VCI组69例。采用实时荧光定量逆转录聚合酶链式反应(qRT-PCR)检测脑卒中病人血清mir-223水平,酶联免疫吸附分析测定血清HMGB1水平,并对两组病人进行NIHSS评分。分析血清mir-223、HMGB1水平与病人临床病理特征的关系;Pearson法分析脑卒中病人血清mir-223与HMGB1水平的关系;Spearman相关性分析血清mir-223、HMGB1水平与NIHSS评分的关系;采用多因素logistic回归分析脑卒中病人并发VCI的影响因素;ROC曲线评估血清mir-223、HMGB1水平对脑卒中后是否并发VCI的预测价值。结果脑卒中后发生VCI组血清mir-223(1.91±0.20比2.15±0.22)显著低于未发生VCI组,HMGB1水平[(5.63±0.57)μg/L比(5.34±0.54)μg/L]、NIHSS评分[(15.41±2.65)分比(3.02±0.57)分]均显著高于未发生VCI组(P<0.05);轻度、中度、重度VCI病人血清mir-223水平依次降低、HMGB1水平依次升高,三组间比较均差异有统计学意义(P<0.05)。脑卒中病人血清mir-223与HMGB1水平呈负相关(r=−0.33,P<0.001);血清mir-223水平与NIHSS评分呈负相关,HMGB1水平与NIHSS评分呈正相关(P<0.05);脑卒中后发生VCI组病人Hcy、CRP水平及高血压、冠心病和心房颤动比例显著高于未发生VCI组(P<0.05);mir-223、HMGB1、Hcy和CRP是脑卒中后并发VCI的影响因素(P<0.05);血清mir-223、HMGB1联合预测脑卒中后VCI发生的AUC为0.89,优于单项检测(Z_(mir-223-联合)=2.40,P=0.016;Z_(HMGB1-联合)=2.09,P=0.037)。结论血清mir-223、HMGB1水平与脑卒中后并发VCI的关系密切,为发生VCI的影响因素,对预测脑卒中后并发VCI具有重要价值。Objective To investigate the relationship between serum levels of microRNA-223(mir-223)and high mobility group protein B1(HMGB1)and vascular cognitive impairment(VCI)after stroke.Methods A total of 100 stroke patients who visited the People's Hospital of Shijiazhuang from August 2021 to December 2022 were collected as the study subjects.They were grouped into a VCI group of 31 patients and a non VCI group of 69 patients based on whether they had concurrent VCI.QRT-PCR method was applied to detect serum mir-223 level in stroke patients,enzyme-linked immunosorbent assay(ELISA)was applied to measure serum HMGB1 level,and NIHSS score was performed on two groups.The relationship between serum mir-223,HMGB1 levels and clinical pathological characteristics of patients was analyzed;Pearson method was applied to analyze the relationship between serum mir-223 and HMGB1 levels in stroke patients;Spearman correlation was applied to analyze the relationship between serum mir-223,HMGB1 levels and NIHSS score;multiple logistic regression was applied to analyze the influencing factors of VCI in stroke patients;ROC curve was applied to evaluate the predictive value of serum mir-223 and HMGB1 levels for the occurrence of VCI after stroke.Results The level of serum mir-223(1.91±0.20 vs.2.15±0.22)in the group with VCI after stroke were obviously lower than those in the group without VCI,and the level of HMGB1[(5.63±0.57)μg/L vs.(5.34±0.54)μg/L]and NIHSS score[(15.41±2.65)points vs.(3.02±0.57)points]were obviously higher than those in the group without VCI(P<0.05);the serum mir-223 level in patients with mild,moderate,and severe VCI decreased in sequence,while HMGB1 level increased in sequence(P<0.05).There was a negative correlation between serum mir-223 and HMGB1 levels in stroke patients(r=−0.33,P<0.01);the serum mir-223 level was negatively correlated with NIHSS score,while the HMGB1 level was positively correlated with NIHSS score(P<0.05);the levels of Hcy and CRP,and the proportions of hypertension,coronary heart dise

关 键 词：高迁移率族蛋白B1 微RNA-223 脑卒中 血管性认知功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]