摘要
目的探讨细胞色素P4502C19(CYP2C19)基因多态性、血清miR-374b-5p水平与急性脑梗死(ACI)患者神经功能缺损和近期预后的关系。方法选取2019年1月—2022年12月郑州市第七人民医院ACI患者164例,收集所有患者的一般资料,并检测CYP2C19基因型和血清miR-374b-5p相对表达量。采用美国国立卫生研究院卒中量表(NIHSS)评估ACI患者神经功能缺损程度。根据治疗15 d后的NIHSS评分将ACI患者分为预后良好组和预后不良组。采用Spearman相关分析评估miR-374b-5p与入院时NIHSS评分的相关性。采用多因素Logistic回归分析评估ACI患者近期预后不良的危险因素。采用受试者工作特征(ROC)曲线评估CYP2C19基因型和血清miR-374b-5p判断ACI患者近期预后的效能。结果164例ACI患者CYP2C19基因型中,GG型(野生纯合子)26例(15.86%)、GA型(突变杂合子)66例(40.24%)、AA型(突变纯合子)72例(43.90%)。A等位基因频率为64.02%,G等位基因频率为35.98%。基因型分布符合Hardy-Weinberg平衡定律(χ^(2)=2.620,P=0.106)。GG基因型、GA基因型、AA基因型的ACI患者入院时NIHSS评分依次升高(P<0.001)。血清miR-374b-5p相对表达量与入院时NIHSS评分呈负相关(r_(s)=-0.510,P<0.001)。ACI患者预后不良发生率为19.51%(32/164)。预后不良组与预后良好组之间年龄、梗死体积、发病至就诊时间、白细胞(WBC)计数、CYP2C19基因型为AA型所占比例和血清miR-374b-5p相对表达量差异均有统计学意义(P<0.05)。梗死体积、发病至就诊时间、WBC计数、CYP2C19基因型为AA型均是ACI患者预后不良的危险因素(P<0.05),miR-374b-5p相对表达量为保护因素(P=0.007)。AA基因型和血清miR-374b-5p单项检测和联合检测判断ACI患者预后不良的曲线下面积(AUC)分别为0.631、0.730、0.802。结论CYP2C19基因多态性、血清mi R-374b-5p相对表达量均与ACI患者神经功能缺损有关,或可作为ACI患者近期预后的评估指标。
Objective To investigate the relationship between cytochrome P4502C19(CYP2C19)polymorphism,serum miR-374b-5p level with neurological impairment and short-term prognosis in patients with acute cerebral infarction(ACI).Methods A total of 164 ACI patients admitted to Zhengzhou Seventh People's Hospital from January 2019 to December 2022 were enrolled.The general data of all the patients were collected,and CYP2C19 genotype and serum miR-374b-5p relative expression levels were determined.The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the degree of neurological impairment in ACI patients.According to the NIHSS score after 15 d of treatment,the ACI patients were classified into good prognosis group and poor prognosis group.Spearman correlation analysis was used to evaluate the correlation between serum miR-374b-5p and NIHSS score at admission.Multivariate Logistic regression analysis was used to evaluate the risk factors for poor short-term prognosis in ACI patients.The efficacy of CYP2C19 genotype and serum miR-374b-5p in determining the short-term prognosis of patients with ACI was evaluated by receiver operating characteristic(ROC)curve.Results Among the 164 ACI patients with CYP2C19 genotype,there were 26 cases(15.86%)of GG type(wild homozygote),66 cases(40.24%)of GA type(mutant heterozygote)and 72 cases(43.90%)of AA type(mutant homozygote).The allele frequency of A was 64.02%,and the allele frequency of G was 35.98%.Genotype distribution was consistent with Hardy-Weinberg equilibrium law(χ^(2)=2.620,P=0.106).The NIHSS scores of GG genotype,GA genotype and AA genotype were increased in turn on admission(P<0.001).The relative expression level of serum miR-374b-5p was negatively correlated with the NIHSS score on admission(r_(s)=-0.510,P<0.001).The incidence of poor prognosis in ACI patients was 19.51%(32/164).There was statistical significance in age,infarct volume,time from onset to treatment,white blood cell(WBC)count,proportion of CYP2C19 AA genotype and relative expression level of ser
作者
赵倩
曾利敏
周丽平
齐林
ZHAO Qian;ZENG Limin;ZHOU Liping;QI Lin(Department of Neurology,Zhengzhou Seventh People's Hospital,Zhengzhou 450016,Henan,China;Department of Clinical Laboratory,Zhengzhou Seventh People's Hospital,Zhengzhou 450016,Henan,China)
出处
《检验医学》
CAS
2024年第6期536-541,共6页
Laboratory Medicine
基金
河南省医学科技攻关计划联合共建项目(LHGJ20210746)。
