脑梗死患者血清miR-181c、miR-128b表达水平及其与90天预后的相关性
|
摘要
目的探讨脑梗死患者血清微小RNA(miRNA)miR-181c、miR-128b表达水平及其与90天预后的相关性,为miRNA在脑梗死诊断和治疗上提供参考意义。方法选取128例脑梗死患者以及同期108例健康体检者作为研究对象,分别作为研究组和对照组。比较两组研究对象的miR-181c和miR-128b表达水平,并分析miR-181c、miR-128b表达水平与疾病严重程度的相关性以及脑梗死相关危险因素;根据90天随访的预后情况分为预后良好组和预后不良组,并对影响90天预后的相关因素进行单因素和Logistic回归分析,探讨影响疾病发生及预后的独立影响因素。结果研究组吸烟、高血脂、高血压、糖尿病以及心房颤动比例明显高于对照组(P<0.05),研究组患者miR-181c、miR-128b表达水平显著高于对照组,差异具有统计学意义(P<0.05),Logistic回归分析结果显示糖尿病、miR-181c、miR-128b表达水平是脑梗死的独立危险因素(P<0.05);Spearman相关性分析显示急性脑梗死患者病情严重程度与血清miR-181c和miR-128b水平呈正相关(r=0.867,P=0.005;r=0.885,P=0.002);预后不良组患者发生高血压、糖尿病、心房颤动的比例和入院时NIHSS评分以及血清miR-181c、miR-128b水平均显著高于预后良好组(P<0.05),Logistic回归分析结果显示入院时NIHSS评分及血清miR-181c、miR-128b水平均与脑梗死患者90天预后存在密切相关性(P<0.05)。结论脑梗死患者血清miR-181c、miR-128b表达水平显著高于健康人群,糖尿病、miR-181c、miR-128b表达水平是脑梗死的危险因素(P<0.05),miR-181c、miR-128b表达水平与患者脑梗死严重程度存在显著正相关,且两者表达水平以及NIHSS评分均与急性脑梗死患者90天预后存在密切联系。
Aim To investigate the expression of serum microRNA(miRNA) miR-181 c and miR-128 b in patients with cerebral infarction and its correlation with 90-day prognosis, and provide reference for the diagnosis and treatment of cerebral infarction. Methods 128 patients with cerebral infarction admitted to our hospital from January 2015 to June 2018 and 108 healthy subjects in the same period were selected as study subjects and control groups. The expression levels of miR-181 c and miR-128 b were compared between the two groups, and the correlation between miR-181 c, miR-128 b expression levels and disease severity, as well as risk factors associated with cerebral infarction were analyzed. According to the prognosis of 90 days follow-up, the good prognosis group and the poor prognosis group were classified, and the factors affecting the prognosis of 90 d were analyzed by single factor and logistic regression analysis to explore the independent influencing factors affecting the occurrence and prognosis of the disease. Results The smoking, hyperlipidemia, hypertension, diabetes and atrial fibrillation rate in the study group were significantly higher than those in the control group(P<0.05), and the expression levels of miR-181 c and miR-128 b in the study group were significantly higher than those in the control group(P<0.05). Logistic regression analysis showed that the diabetes and expression levels of miR-181 c and miR-128 b were independent risk factors for cerebral infarction(P<0.05); Spearman correlation analysis showed that the severity of acute cerebral infarction was positively correlated with serum miR-181 c and miR-128 b levels(r=0.867, P=0.005; r=0.885, P=0.002); The incidence of hypertension, diabetes, atrial fibrillation, NIHSS score at admission, and serum miR-181 c and miR-128 b levels were significantly higher in patients with poor prognosis than those with good prognosis(P<0.05). Conclusion Logistic regression analysis showed that NIHSS score and serum miR-181 c and miR-128 b levels were significantly correlated with the 90-day prognosis of patients with acute cerebral infarction.
Aim To investigate the expression of serum microRNA(miRNA) miR-181 c and miR-128 b in patients with cerebral infarction and its correlation with 90-day prognosis, and provide reference for the diagnosis and treatment of cerebral infarction. Methods 128 patients with cerebral infarction admitted to our hospital from January 2015 to June 2018 and 108 healthy subjects in the same period were selected as study subjects and control groups. The expression levels of miR-181 c and miR-128 b were compared between the two groups, and the correlation between miR-181 c, miR-128 b expression levels and disease severity, as well as risk factors associated with cerebral infarction were analyzed. According to the prognosis of 90 days follow-up, the good prognosis group and the poor prognosis group were classified, and the factors affecting the prognosis of 90 d were analyzed by single factor and logistic regression analysis to explore the independent influencing factors affecting the occurrence and prognosis of the disease. Results The smoking, hyperlipidemia, hypertension, diabetes and atrial fibrillation rate in the study group were significantly higher than those in the control group(P<0.05), and the expression levels of miR-181 c and miR-128 b in the study group were significantly higher than those in the control group(P<0.05). Logistic regression analysis showed that the diabetes and expression levels of miR-181 c and miR-128 b were independent risk factors for cerebral infarction(P<0.05); Spearman correlation analysis showed that the severity of acute cerebral infarction was positively correlated with serum miR-181 c and miR-128 b levels(r=0.867, P=0.005; r=0.885, P=0.002); The incidence of hypertension, diabetes, atrial fibrillation, NIHSS score at admission, and serum miR-181 c and miR-128 b levels were significantly higher in patients with poor prognosis than those with good prognosis(P<0.05). Conclusion Logistic regression analysis showed that NIHSS score and serum miR-181 c and miR-128 b levels were significantly correlated with the 90-day prognosis of patients with acute cerebral infarction.
引文
[1] Naess H,Kurtz M,Thomassen L,et al.Serial NIHSS scores in patients with acute cerebral infarction[J].Acta Neurol Scand,2016,133(6):415-420.
[2] Niu J,Xue A,Chi Y,et al.Induction of miRNA-181a by genotoxic treatments promotes chemotherapeutic resistance and metastasis in breast cancer[J].Oncogene,2016,35(10):1302-1313.
[3] Choi GH,Ko KH,Kim JO,et al.Association of miR-34a,miR-130a,miR-150 and miR-155 polymorphisms with the risk of ischemic stroke[J].Int J Mol Med,2016,38(1):345-352.
[4] Fang C,Li Q,Min G,et al.MicroRNA-181c ameliorates cognitive impairment induced by chronic cerebral hypoperfusion in rats[J].Mol Neurobiol,2017,54(10):1-16.
[5] 王新德.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,12(6):379-380.
[6] 江丽杰,胡镜清,易丹辉,等.基于广义估计方程的缺血性中风病中医证候要素动态变化与NIHSS评分变化纵向相关性分析[J].中国中医基础医学杂志,2017,23 (2):221-225.
[7] 周佩莉,袁怀武,计仁杰,等.缺血性卒中急性期患者认知障碍症状学的分型[J].中国脑血管病杂志,2016,13(6):281-286.
[8] Gambari R,Brognara E,Spandidos DA,et al.Targeting oncomiRNAs and mimicking tumor suppressor miRNAs:new trends in the development of miRNA therapeutic strategies in oncology (Review)[J].Int J Oncol,2016,49(1):5-32.
[9] 甘晴,陈洁晶,欧明林,等.非编码RNA相关重大疾病发病机制和生物标志物筛选的研究进展[J].医学综述,2016,22(18):3565-3568.
[10] Chen SJ,Wu P,Sun LJ,et al.miR-204 regulates epithelial-mesenchymal transition by targeting SP1 in the tubular epithelial cells after acute kidney injury induced by ischemia-reperfusion[J].Oncol Rep,2017,37(2):1148-1156.
[11] 杨书英,王勇强,王兵,等.替格瑞洛与氯吡格雷联合阿司匹林对糖尿病合并急性脑梗死患者神经功能恢复及血清VEGF、MMP-9、Ang-Ⅱ的影响[J].中国新药与临床杂志,2017,36(12):744-747.
[12] 彭彬,吴大玉,孙家兰,等.急性脑梗死早期血中miRNAs水平与脑侧支循环建立的关系[J].中风与神经疾病杂志,2016,33(2):100-103.
[13] 张仕娟,刘月华,李乃坤,等.急性脑梗死患者血清miR-181c水平与认知功能受损的关系[J].山东医药,2016,56(38):90-92.
[14] 杜守治,董斌,齐中华.急性心肌梗死和急性脑梗死miRNA疾病标志物的初步筛查[J].中国医科大学学报,2017,46(8):681-685.
[15] Naess H,Kurtz M,Thomassen L,et al.Serial NIHSS scores in patients with acute cerebral infarction[J].Acta Neurol Scand,2016,133(6):415-420.
[2] Niu J,Xue A,Chi Y,et al.Induction of miRNA-181a by genotoxic treatments promotes chemotherapeutic resistance and metastasis in breast cancer[J].Oncogene,2016,35(10):1302-1313.
[3] Choi GH,Ko KH,Kim JO,et al.Association of miR-34a,miR-130a,miR-150 and miR-155 polymorphisms with the risk of ischemic stroke[J].Int J Mol Med,2016,38(1):345-352.
[4] Fang C,Li Q,Min G,et al.MicroRNA-181c ameliorates cognitive impairment induced by chronic cerebral hypoperfusion in rats[J].Mol Neurobiol,2017,54(10):1-16.
[5] 王新德.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,12(6):379-380.
[6] 江丽杰,胡镜清,易丹辉,等.基于广义估计方程的缺血性中风病中医证候要素动态变化与NIHSS评分变化纵向相关性分析[J].中国中医基础医学杂志,2017,23 (2):221-225.
[7] 周佩莉,袁怀武,计仁杰,等.缺血性卒中急性期患者认知障碍症状学的分型[J].中国脑血管病杂志,2016,13(6):281-286.
[8] Gambari R,Brognara E,Spandidos DA,et al.Targeting oncomiRNAs and mimicking tumor suppressor miRNAs:new trends in the development of miRNA therapeutic strategies in oncology (Review)[J].Int J Oncol,2016,49(1):5-32.
[9] 甘晴,陈洁晶,欧明林,等.非编码RNA相关重大疾病发病机制和生物标志物筛选的研究进展[J].医学综述,2016,22(18):3565-3568.
[10] Chen SJ,Wu P,Sun LJ,et al.miR-204 regulates epithelial-mesenchymal transition by targeting SP1 in the tubular epithelial cells after acute kidney injury induced by ischemia-reperfusion[J].Oncol Rep,2017,37(2):1148-1156.
[11] 杨书英,王勇强,王兵,等.替格瑞洛与氯吡格雷联合阿司匹林对糖尿病合并急性脑梗死患者神经功能恢复及血清VEGF、MMP-9、Ang-Ⅱ的影响[J].中国新药与临床杂志,2017,36(12):744-747.
[12] 彭彬,吴大玉,孙家兰,等.急性脑梗死早期血中miRNAs水平与脑侧支循环建立的关系[J].中风与神经疾病杂志,2016,33(2):100-103.
[13] 张仕娟,刘月华,李乃坤,等.急性脑梗死患者血清miR-181c水平与认知功能受损的关系[J].山东医药,2016,56(38):90-92.
[14] 杜守治,董斌,齐中华.急性心肌梗死和急性脑梗死miRNA疾病标志物的初步筛查[J].中国医科大学学报,2017,46(8):681-685.
[15] Naess H,Kurtz M,Thomassen L,et al.Serial NIHSS scores in patients with acute cerebral infarction[J].Acta Neurol Scand,2016,133(6):415-420.