目的 研究miR-181a、半乳凝素-3(galectin-3,GAL3)在急性缺血性脑卒中(acute ischemic stroke,AIS)病情及预后评估中的临床价值.方法 选取 2019 年 1 月至 2021 年 1 月诊治的 82 例AIS患者(AIS组)和 40 例同期无缺血性脑卒中的颅脑血管疾病患者(对照组)为研究对象,比较两组患者的血清 miR-181a、GAL3、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、改良Barthel指数评定量表(modified Barthel index,MBI)及Fugl-Meyer肢体运动功能(Fugl-Meyer assessment of gait,FMA)评分的差异.Pearson相关性分析miR-181a、GAL3 与神经功能指标(NIHSS、MBI、FMA评分)的相关性.采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析miR-181a、GAL3 预测AIS患者 1 年预后不良的效能.Logistic回归分析AIS患者 1 年死亡的危险因素.结果 与对照组比较,AIS组患者的miR-181a、GAL3、NIHSS评分显著增高(P<0.05);MBI及FMA评分均显著降低(P<0.05).AIS组患者的miR-181a、GAL3 与NIHSS评分呈正相关(r>0,P<0.05);与MBI评分、FMA评分呈负相关(r<0,P<0.05).miR-181a、GAL3 预测AIS组患者 1 年预后不良的敏感度、特异性、曲线下面积(area under the curve,AUC)均高于NIHSS评分、MBI评分、FMA评分;miR-181a联合GAL3 预测AIS组患者 1 年预后不良的敏感度、特异性、AUC均高于miR-181a、GAL3、NIHSS评分、MBI评分、FMA评分.miR-181a≥1.3、GAL3≥12.3ng/ml、NIHSS评分≥17.4 分、MBI评分<67.6 分、FMA评分<84.2 分为AIS患者 1 年死亡的独立危险因素(P<0.05).结论 AIS患者血清miR-181a及GAL3 水平明显增高,在AIS病情及预后评估中具有一定的临床价值.
Clinical value of miR-181a and GAL3 in the evaluation of the condition and prognosis of acute ischemic stroke
Objective To study the clinical value of miR-181a and galectin-3(GAL3)in the assessment of the condition and prognosis of acute ischemic stroke(AIS).Methods A total of 82 AIS patients(AIS group)diagnosed and treated from January 2019 to January 2021 and patients with cerebrovascular disease without ischemic stroke during the same period(control group)were selected as the research subjects,and the serum miR-181a,GAL3,National Institute of Health stroke scale(NIHSS),modified Barthel index(MBI)and Fugl-Meyer assessment of gait(FMA)of the two groups were compared.Pearson correlation analysis was performed on the correlation between miR-181a,GAL3 and neurological function indicators(NIHSS,MBI,FMA score).Receiver operating characteristic curve(ROC)was used to analyze the effectiveness of miR-181a and GAL3 in predicting poor 1-year prognosis in AIS patients.Logistic regression analysis of risk factors for 1-year death in postmenstrual AIS patients.Results Compared with control group,the miR-181a,GAL3,and NIHSS scores of patients in AIS group were significantly higher(P<0.05),and the MBI score and FMA score were significantly lower(P<0.05).In AIS group,patients'miR-181a and GAL3 were positively correlated with the NIHSS score(r>0,P<0.05),and were negatively correlated with the MBI score and FMA score(r<0,P<0.05).The sensitivity,specificity,and area under the curve(AUC)of miR-181a and GAL3 in predicting poor 1-year prognosis of AIS patients in the AIS group are higher than the NIHSS score,MBI score,and FMA score;The sensitivity of miR-181a combined with GAL3 in predicting poor 1-year prognosis in patients in AIS group,specificity,and AUC were all higher than miR-181a,GAL3,NIHSS score,MBI score,and FMA score.miR-181a≥1.3,GAL3≥12.3ng/ml,NIHSS score≥17.4 points,MBI score<67.6 points,and FMA score<84.2 points were independent risk factors for 1-year death in AIS patients(P<0.05).Conclusion The serum levels of miR-181a and GAL3 in AIS patients are significantly increased,which have certain clinical value in the evaluation of the condition and prognosis of AIS.
Acute ischemic strokemiR-181aGAL3ConditionPrognosisClinical value
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