摘要
目的探讨颈动脉狭窄患者血浆微小RNA(micro ribonucleic acid,miR)分子水平与脑侧支循环形成的相关性。方法本研究为横断面调查,入选2017年1月至2018年10月在上海公利医院经超声筛查确诊为颈动脉狭窄超过30%的患者60例。经脑数字减影血管造影,评估脑内侧支循环建立情况。实时荧光定量聚合酶链式反应法测定患者血浆中miR-92-3p、miR-15a-3p、miR-16-3p、miR-126-3p、miR-210-3p和miR-132-3p的表达水平。比较各组间一般临床资料及颈动脉狭窄程度、脑侧支循环是否建立与血浆miR水平的关系,并用多因素logistic回归和受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血浆miR水平对颈动脉狭窄患者脑内侧支循环建立的预测能力。结果按中华医学会《缺血性卒中侧支循环评估与干预中国指南(2017)》纳入狭窄<50%组17例、狭窄50%~70%组21例以及狭窄>70%组22例,经性别、饮酒史及颈动脉狭窄程度校正后,logistic回归结果显示,miR-92a-3p是侧支循环建立的抑制因素[比值比(odds ratio,OR)=0.21],而miR-126-3p、miR-132-3p和miR-210-3p促进侧支循环建立(OR分别为6.10、1.91和3.09)。ROC提示这4种miR对侧支循环开放具有预测效能(曲线下面积:0.918~0.942),其中miR-126-3p效能最高。结论血浆中miR-92、miR-126、miR-210和miR-132的表达水平对颈动脉狭窄患者脑侧支循环建立均有一定的诊断价值。
Objection To investigate the correlation between plasma microRNAs(miR)and cerebral collateral circulation in patients with carotid stenosis.Methods In this cross-sectional study,60 patients with carotid artery stenosis over 30%confirmed by ultrasound screening at Shanghai Gongli Hospital from Jan 2017 to Oct 2018 were enrolled.Cerebral digital subtraction angiography was used to evaluate the establishment of collateral circulation.Real-time fluorescence quantitative polymerase chain reaction was used to determine the expression levels of miR-92-3p,miR-15a-3p,miR-16-3p,miR-126-3p,miR-210-3p and miR-132-3p.The general clinical data,degree of carotid stenosis and the relationship between the establishment of cerebral collateral circulation and plasma miR level was compared among the three groups.Multivariate logistic regression and receiver operating characteristic curve(ROC)were used to analyze the predictive ability of plasma miR levels to establish cerebral collateral circulation in patients with carotid stenosis.Results According to the Guidelines for Evaluation and Management of Cerebral Collateral Circulation in Ischemic Stroke(2017)by the Chinese Medical Association,17 cases were included in the 30%-50%carotid stenosis group,21 cases in the 50%-70%carotid stenosis group,and 22 cases in the 70%-99%carotid stenosis group.After adjusting for gender,drinking history and degree of carotid stenosis,logistic regression results showed that miR-92A-3p was negatively correlated with collateral circulation[(odds ratio,OR)=0.21].miR-126-3p,miR-132-3p and miR-210-3p were positively correlated with collateral circulation(OR were 6.10,1.91 and 3.09).ROC suggested that these four miR had predictive efficacy for collateral circulation establishment(area under curve:0.918-0.942),among which miR-126-3p had the highest efficacy.Conclusion The expression levels of miR-92,miR-126,miR-210 and miR-132 in plasma have certain diagnostic value for establishing cerebral collateral circulation in patients with carotid stenosis.
作者
荆丽萨
彭彬
吴大玉
杨雪莲
周孝雯
李龙宣
黄丙仓
陈玮
JIN Lisa;PENG Bin;WU Dayu;YANG Xuelian;ZHOU Xiaowen;LI Longxuan;HUANG Bincang;CHEN Wei(Department of Radiology,Gongli Hospital,Pudong New Area,Shanghai 200135,China;Central Laboratory,Gongli Hospital,Pudong New Area,Shanghai 200135,China;Department of Neurology,Gongli Hospital,Pudong New Area,Shanghai 200135,China)
出处
《世界临床药物》
CAS
2023年第1期59-65,共7页
World Clinical Drug
基金
上海市卫健委面上项目(201640396)
上海市医学重点专科资助(ZK2019A08)
上海市浦东新区卫生系统重点学科建设资助(PWZxk2017-26)。
