摘要
目的:探讨缺血性脑卒中患者外周血微小核糖核酸的表达水平变化及其与炎性因子水平的相关性.方法:选择2020年6月至2024年6月期间,张家口市第五医院缺血性脑卒中患者150例作为研究对象,同时选择同期110例无心脑血管病健康志愿者作为对照组.根据阿尔伯塔卒中项目早期CT(Alberta stroke program early CT score,ASPECTS)评分将缺血性脑卒中患者分为大梗死体积组(ASPECTS评分≤4,55例)和小梗死体积组(ASPECTS评分≥5,95例),并根据卒中量表(national institute ofhealth stroke scale,NIHSS)评分分为轻度组(NIHSS评分＜7 分,100例)和中、重度组(NIHSS评分≥7分,50例).采用实时荧光定量反转录聚合酶链反应(reverse transcription quantitative real-time polymerase chain reaction,RT-qPCR)检测所有对象血清中微小 RNA-155(mi-croRNA-155,miR-155)水平,酶联免疫吸附试验法测定所有患者血清IL-6、TNF-α及CRP水平.采用Pearson法分析脑梗死患者miR-155与相关炎性因子及病情严重程度之间的关系;分析miR-155对缺血性脑卒中的诊断价值.结果:大梗死体积组、小梗死体积组血清miR-155、IL-6、TNFα及CRP表达水平均高于对照组,且大梗死体积组血清miR-155、IL-6、TNFα及CRP表达水平均高于小梗死体积组(P＜0.05).中、重度组血清miR-155、IL-6、TNF-α及CRP水平高于轻度组(P＜0.05).缺血性脑卒中患者血清 miR-155 与 IL-6、TNF-α 及 CRP 水平均呈正相关(r=0.392、0.347、0.324,P均＜0.05);与NIHSS评分呈正相关(r=0.368,P＜0.05);miR-155诊断缺血性脑卒中的AUC为0.918,灵敏度为89.0％,特异度为82.1％,约登指数为0.7,截断值0.868,阳性预测值和阴性预测值分别为90.3％、89.8％.结论:缺血性脑卒中患者的miR-155水平与炎性因子水平存在密切关系,可对疾病严重程度进行判断,成为预测疾病预后的重要指标.
Abstract
Objective:To explore the peripheral blood microRNA profiles in individuals suffering from ischemic stroke and to analyze their association with inflammatory markers.Methods:From June 2020 through June 2024,a cohort of 150 ischemic stroke patients admitted to the Fifth Hospital in Zhangjiakou City were enrolled as the research participants.Concurrently,a control group consisting of 110 healthy individuals without cardiovascular or cerebrovascular diseases was assembled.The ischemic stroke participants were categorized into two groups based on the Alberta stroke program early CT score(ASPECTS):A group with a large infarct size(ASPECTS score ≤ 4,n=55)and a group with a small infarct size(ASPECTS score ≥ 5,n=95).Furthermore,they were stratified into a mild stroke group(National Institutes of Health Stroke Scale,NIHSS score＜7,n=100)and a moderate to severe stroke group(NIHSS score ≥ 7,n=50).Serum levels of microRNA-155(miR-155)were quantified using reverse transcription quantitative real-time polymerase chain reaction(RT-qPCR).Additionally,the concentrations of IL-6,TNF-α,and CRP in serum were measured via enzyme-linked immunosorbent assay(ELISA).Correlations between miR-155 and the inflammatory markers,as well as the disease severity in cerebral infarction patients,were assessed using the Pearson correlation method.The study also aimed to evaluate the utility of miR-155 as a diagnostic biomarker for ischemic stroke.Results:The serum levels of miR-155,IL-6,TNFα,and CRP in both the large infarct volume group and the small infarct volume group were significantly elevated compared to the control group.Furthermore,the serum concentrations of these markers in the large infarct volume group were higher than those in the small infarct volume group(P＜0.05).The levels of miR-155,IL-6,TNF-α,and CRP in the moderate to severe groups were higher than those in the mild group(P＜0.05).In ischemic stroke patients,there was a positive correlation between serum miR-155 and the levels of IL-6,TNF-α,and CRP(r=0.392,0.347,0.324,respectively,all P＜0.05);there was also a positive correlation with the NIHSS score(r=0.368,P＜0.05).The AUC for miR-155 in diagnosing ischemic stroke was 0.918,with a sensitivity of 89.0％,a specificity of 82.1％,a Youden index of 0.711,a cutoff value of 0.868,and positive and negative predictive values of 90.3％and 89.8％,respectively.Conclusion:The findings indicate that miR-155 levels in ischemic stroke patients are intimately linked to inflammatory marker levels,serving as a crucial marker for disease severity assessment and as a prognostic indicator for predicting patient outcomes.
维普
万方数据