摘要
目的探讨血清小而密低密度脂蛋白胆固醇(sdLDL)、微小RNA-424(miR-424)、胰岛素样生长因子-1(IGF-1)表达与脑梗死溶栓治疗效果的关联性及其预测价值。方法选取2018-03—2020-02郑州大学附属郑州中心医院治疗的脑梗死患者129例,比较不同脑梗死面积、斑块性质、溶栓效果及预后患者血清sdLDL、miR-424、IGF-1表达水平,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析sdLDL、miR-424、IGF-1预测脑梗死预后的截断值、敏感度、特异度,采用Pearson分析预后不良患者sdLDL、miR-424、IGF-1的关联性。结果miR-424、IGF-1水平比较,大面积脑梗死<中面积脑梗死<小面积脑梗死;sdLDL水平比较,大面积脑梗死>中面积脑梗死>小面积脑梗死(P<0.05)。不稳定斑块脑梗死患者miR-424、IGF-1水平低于稳定斑块患者,sdLDL表达水平高于稳定斑块患者(P<0.05)。疗效良好者miR-424、IGF-1水平高于疗效不佳者,sdLDL水平低于疗效不佳者(P<0.05)。预后良好者miR-424、IGF-1水平高于预后不良者,sdLDL水平低于预后不良者(P<0.05)。预测脑梗死预后不良的AUC、截断值sdLDL分别为0.787、>2.38 mmol/L,miR-424分别为0.806、≤6.61,IGF-1分别为0.751、≤106.25 ng/mL(P<0.05);sdLDL+miR-424+IGF-1预测脑梗死预后不良的AUC、敏感度、特异度分别为0.896、75.00%、92.92%(P<0.05);脑梗死预后不良患者sdLDL水平与miR-424、IGF-1呈负相关,miR-424与IGF-1呈正相关(P<0.05)。结论血清sdLDL、miR-424、IGF-1表达与脑梗死斑块性质、梗死面积、溶栓治疗效果、预后有关,能相互影响并参与脑梗死发病与病情的进展,检测三者表达有望成为预测患者预后新的生物标志物。
Objective To investigate the correlation and predictive value of serum expression of small and dense low-density lipoprotein cholesterol(sdLDL),microRNA-424(miR-424),insulin-like growth factor-1(IGF-1)with the prognostic effect of thrombolytic therapy for cerebral infarction.Methods A total of 129 patients with cerebral infarction in our hospital from March 2018 to February 2020 were selected to compare the serum expression levels of sdLDL,miR-424 and IGF-1 in patients with different cerebral infarction area,plaque nature,thrombolytic effect and prognosis.The receiver operating characteristic curve(ROC)and area under ROC(AUC)were used to analyze sdLDL,miR-424,and IGF-1 to predict the cutoff value,sensitivity,and specificity of the prognosis of cerebral infarction,Pearson was used to analyze the association between sdLDL,miR-424 and IGF-1 in patients with poor prognosis.Results Comparison of miR-424 and IGF-1 levels,large area cerebral infarction<medium area cerebral infarction<small area cerebral infarction.Comparison of sdLDL levels,large area cerebral infarction>medium area cerebral infarction>small area cerebral infarction(P<0.05).Patients with unstable plaque cerebral infarction had lower miR-424 and IGF-1 levels than patients with stable plaques,and sdLDL expression levels were higher than those with stable plaques(P<0.05).The miR-424 and IGF-1 levels of those with good efficacy were higher than those with poor efficacy,and the sdLDL levels were lower than those with poor efficacy(P<0.05).Those with good prognosis had higher miR-424 and IGF-1 levels than those with poor prognosis,and sdLDL levels were lower than those with poor prognosis(P<0.05).AUC and cutoff value for predicting poor prognosis of cerebral infarctionsdLDL was 0.787,>2.38 mmol/L;miR-424 was 0.806,≤6.61;IGF-1 was 0.751,≤106.25 ng/mL(P<0.05);sdLDL+miR-424+IGF-1 to predict the poor prognosis AUC and sensitivity,specificity of cerebral infarction were 0.896,75.00%,92.92%(P<0.05);in patients with poor prognosis of cerebral infarction,sdLDL levels were negatively correlated with miR-424 and IGF-1,and miR-424 was positively correlated with IGF-1(P<0.05).Conclusion The expressions of serum sdLDL,miR-424 and IGF-1 are related to the nature of cerebral infarction plaque,infarct size,thrombolytic therapy effect and prognosis,and can influence each other to participate in the progression of cerebral infarction incidence and condition,detection of the expression of the three is expected to become a new biomarker to predict the prognosis of patients.
作者
何诺
谢林森
董丽
任江龙
HE Nuo;XIE Linsen;DONG Li;REN Jianglong(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China)
出处
《中国实用神经疾病杂志》
2020年第21期1859-1865,共7页
Chinese Journal of Practical Nervous Diseases
基金
2018年度河南省医学科技攻关计划项目(编号:2018020768)
河南省2017年科技发展计划项目(编号:172102310205)。
