摘要
目的探讨miR-29c-3p与缺血性脑卒中患者疾病严重程度及短期预后的关系。方法选取2019年1月至2019年12月我院收治的126例经头颅MRI确诊为缺血性脑卒中患者作为观察组,并选取同期体检无异常的80例健康者作为对照组。采用NIHSS对缺血性脑卒中患者进行神经功能缺损评分,根据患者神经功能缺损严重程度将患者分为轻度组(42例)、中度组(46例)、重度组(38例)。随访6个月内患者预后情况,采用mRS评分评估患者短期预后情况,将患者分为预后良好组(89例)和预后不良组(37例),采用实时荧光PCR法检测miR-29c-3p的表达,分析miR-29c-3p与缺血性脑卒中患者疾病严重程度及短期预后的关系。结果观察组患者高血压的比例及超敏C反应蛋白(hs-CRP)、空腹血糖水平明显高于对照组,而miR-29c-3p相对表达量明显低于对照组(均P<0.05)。重度组患者miR-29c-3p相对表达量(0.56±0.13)明显低于中度组(0.71±0.22)和轻度组(0.86±0.24),三组间两两比较差异均有统计学意义(均P<0.05)。预后不良组患者糖尿病的比例及NIHSS评分、hs-CRP、空腹血糖水平均明显高于预后良好组,miR-29c-3p相对表达量明显低于预后良好组(均P<0.05)。ROC曲线分析结果显示,miR-29c-3p相对表达量截断值为0.78时,预测缺血性脑卒中患者短期预后的ROC曲线下面积为0.76(95%CI:1.236~3.472),此时的敏感度和特异度分别为78.45%和68.39%。多因素Logistic回归分析结果显示,糖尿病(OR=3.111,95%CI:1.283~7.545)、NIHSS评分(OR=3.442,95%CI:1.297~9.135)、hs-CRP(OR=3.149,95%CI:1.044~9.492)、miR-29c-3p(OR=3.187,95%CI:1.353~7.505)是缺血性脑卒中患者预后不良的独立危险因素。结论miR-29c-3p表达量越低,缺血性脑卒中患者疾病严重程度越重。miR-29c-3p低表达是缺血性脑卒中患者短期预后不良的独立影响因素。miR-29c-3p表达对临床治疗及预后评估具有重要指导意义。
Objective To investigate the relationship between miR-29 c-3 p and disease severity and short-term prognosis in patients with ischemic stroke.Methods A total of 126 patients admitted to our hospital from January 2019 to December 2019 who were diagnosed with ischemic stroke by head MRI were selected as the observation group,and 80 healthy patients without abnormal physical examination during the same period were selected as the control group.NIHSS was used to score the neurological deficits of patients with ischemic stroke.According to the severity of neurological deficits,patients were divided into mild group(42 cases),moderate group(46 cases)and severe group(38 cases).The prognosis of the patients was followed up within 6 months.The short-term prognosis of the patients was evaluated by mRS scale,and the patients were divided into good prognosis group(89 cases)and poor prognosis group(37 cases).The expression of miR-29 c-3 p was detected by real-time PCR,and the relationship between miR-29 c-3 p and disease severity and short-term prognosis of patients with ischemic stroke was analyzed.Results The proportion of hypertension,hypersensitive C-reactive protein(hs-CRP)and glucose levels in observation group were significantly higher than those in control group,while the relative expression of miR-29 c-3 p was significantly lower than that in control group(all P<0.05).The relative expression of miR-29 c-3 p in the severe group(0.56±0.13)was significantly lower than that in the moderate group(0.71±0.22)and the mild group(0.86±0.24),and there were statistically significant differences among the three groups(all P<0.05).The proportion of diabetes,NIHSS score,hs-CRP and glucose levels in the poor prognosis group were significantly higher than those in the good prognosis group,and the relative expression of miR-29c-3p was significantly lower than that in the good prognosis group(allP<0.05).ROC curve analysis results showed that when the relative expression truncation value of miR-29c-3p was 0.78,the area under ROC curve
作者
张玲
赵小辉
王洪志
耿彪
ZHANG Ling;ZHAO Xiao-hui;WANG Hong-zhi(Department of Laboratory,Baoding Second Central Hospital,Baoding 072750,China)
出处
《临床神经病学杂志》
CAS
2022年第2期119-124,共6页
Journal of Clinical Neurology
基金
保定市科技计划项目(2041ZF225)。
