血清微小RNA-34b、微小RNA-181c与急性缺血性脑卒中患者机械取栓治疗预后关系研究  

Relationship between serum miR-34b,miR-181c and the prognosis of mechanical thrombectomy therapy in patients with acute ischemic stroke

作　　者：王雨婵 李莎[1] 赵新[1] WANG Yuchan;LI Sha;ZHAO Xin(Department of Rehabilitation Medicine,the Third People’s Hospital of Chengdu,Chengdu 610031,China)

机构地区：[1]成都市第三人民医院康复医学科,四川成都610031

出　　处：《陕西医学杂志》2025年第5期640-644,共5页Shaanxi Medical Journal

基　　金：四川省医学(青年创新)科研课题(S211273)。

摘　　要：目的:分析血清微小RNA(miR)-34b、miR-181c与急性缺血性脑卒中(AIS)患者机械取栓治疗预后的关系。方法:选取132例接受机械取栓治疗的AIS患者,于取栓前及取栓后3、7 d检测血清miR-34b、miR-181c水平,并根据出院后90 d随访预后情况分为预后良好组和预后不良组。采用Spearman法分析血清miR-34b、miR-181c水平与血清炎症因子水平及患者预后的相关性;交互作用系数γ分析交互影响及作用类型;血清miR-34b、miR-181c对AIS患者机械取栓治疗预后的预测价值通过绘制受试者工作特征(ROC)曲线进行分析。结果:随访90 d,132例AIS患者中失访4例,其余患者中87例(67.97%)患者预后良好,41例(32.03%)患者预后不良。取栓前及取栓后3、7 d,预后良好组血清miR-34b水平高于预后不良组,血清miR-181c水平低于预后不良组(均P<0.05)。取栓前及取栓后3、7 d,预后良好组血清白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、IL-1β水平低于预后不良组(均P<0.05)。血清miR-34b水平与血清IL-10、TNF-α、IL-1β水平及患者预后呈负相关,血清miR-181c与血清IL-10、TNF-α、IL-1β水平及患者预后呈正相关(均P<0.05)。血清miR-34b低表达与miR-181c高表达呈正向交互作用,为次相乘模型。取栓前及取栓后3、7 d,miR-34b、miR-181c联合预测AIS患者机械取栓治疗预后不良的曲线下面积(AUC)大于两者分别单独预测的AUC,且取栓后7 d miR-34b、miR-181c联合预测的AUC最大(均P<0.05)。结论:血清miR-34b、miR-181c水平与AIS患者机械取栓治疗预后有关,miR-34b低表达与miR-181c高表达呈正向交互作用,两者联合检测对AIS患者机械取栓治疗预后有较高的预测效能。Objective:To analyze the relationship between serum miR-34b,miR-181c and the prognosis of mechanical thrombectomy therapy in patients with acute ischemic stroke(AIS).Methods:A total of 132 patients with AIS who underwent mechanical thrombectomy were selected.Serum levels of miR-34b and miR-181c were detected before thrombectomy and at 3 and 7 days after thrombectomy.Patients were divided into good-prognosis and poor-prognosis groups based on the 90-day follow-up after discharge.Spearman correlation analysis was used to assess the correlation between serum miR-34b,miR-181c levels,serum inflammatory factors and patient prognosis.Interaction coefficientγwas used to analyze the interaction effects and types of interactions.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of serum miR-34b and miR-181c for the prognosis of mechanical thrombectomy therapy in AIS patients.Results:During the 90-day follow-up,4 patients of 132 AIS patients were lost.Among the remaining patients,87(67.97%)had a good prognosis,and 41(32.03%)had a poor prognosis.Before thrombectomy and at 3 and 7 days after thrombectomy,serum miR-34b levels were higher in the good-prognosis group than in the poor-prognosis group,while serum miR-181c levels were lower(all P<0.05).Serum levels of interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),and IL-1βwere also lower in the good-prognosis group than in the poor-prognosis group before and at 3 and 7 days after thrombectomy(all P<0.05).Serum miR-34b levels were negatively correlated with serum IL-10,TNF-α,IL-1βlevels and patient prognosis,while serum miR-181c levels were positively correlated(all P<0.05).Low expression of serum miR-34b and high expression of miR-181c showed a positive interaction effect,fitting a submultiplicative model.The combined prediction of miR-34b and miR-181c for poor prognosis in AIS patients undergoing mechanical thrombectomy had a larger AUC than individual predictions at all time points,with the highest AUC at 7 days after thrombect

关 键 词：急性缺血性脑卒中 微小RNA-34b 微小RNA-181c 机械取栓 预后 交互作用 

分 类 号：R743.3[医药卫生—神经病学与精神病学]