摘要
目的 探讨血清微小RNA-210(microRNA-210,miR-210)和缺氧诱导因子1α(hypoxia inducible factor-1α,HIF-1α)在急性缺血性脑卒中(acute ischemic stroke, AIS)患者血管内治疗前后的变化。方法 选取2023年1月至2024年3月西宁市第一人民医院神经内科收治的AIS患者60例,根据发病3个月改良的Rankin量表(modified Rankin's scale, mRS)评分分为预后良好组41例(0~2分)和预后不良组19例(3~6分)。检测和比较AIS患者治疗前及治疗后3 d和7 d血清miR-210、HIF-1α表达。比较预后良好组与预后不良组治疗前及治疗后3 d和7 d血清miR-210、HIF-1α表达。采用Spearman相关性分析AIS患者预后与血清miR-210、HIF-1α表达的相关性。ROC曲线分析治疗前后血清miR-210、HIF-1α表达的预测价值,并计算曲线下面积(area under curve, AUC)。结果 与治疗前比较,AIS患者治疗后3 d和7 d miR-210和HIF-1α表达显著升高,差异有统计学意义(P<0.05);与治疗后3 d比较,AIS患者治疗后7 d miR-210表达显著升高,HIF-1α表达显著降低,差异有统计学意义(P<0.05)。Spearman相关性分析显示,AIS患者治疗前血清miR-210表达与预后呈负相关(r=-0.271,P<0.05),血清HIF-1α表达与预后呈正相关(r=0.398,P<0.05)。预后不良组miR-210、HIF-1α表达显著高于预后良好组,差异有统计学意义(P<0.01)。ROC曲线分析显示,miR-210检测预后的AUC为0.818,特异性为0.850,敏感性为0.800;HIF-1α检测预后的AUC为0.815,特异性为0.700,敏感性为0.800;miR-210和HIF-1α联合检测预后的AUC为0.880,敏感性为0.900,联合检测显著高于单独检测(P<0.01)。结论 AIS患者术后血清miR-210、HIF-1α表达与mRS评分密切相关。miR-210和HIF-1α联合检测可提高预测的准确性。
Objective To explore the changes in serum microRNA-210(miR-210)and hypoxia-inducible factor(HIF-1α)levels before and after endovascular treatment in patients with acute ischemic stroke(AIS).Methods A total of 60 AIS patients admitted to the Neurology Depart-ment of Xining First People's Hospital from January 2023 to March 2024 were recruited,and based on the modified Rankin Scale(mRS)score in 3 months after onset,they were divided into a good prognosis group(41 cases,mRS score:0一2)and a poor prognosis group(19 cases,mRS score:3-6).Serum levels of miR 210 and HIF-1a were measured and compared before treatment,and at 3 and 7 d after treatment,and the levels were also compared between the good and poor prognosis groups before treatment and at 3 and 7 d after treatment.Spearman correlation analysis was used to evaluate the relationship between prognosis and serum miR-210 and HIF-1α levels in AIS patients.ROC curve analysis was performed to assess the predictive value of serum miR 210 and HIF-1a levels for prognosis.Results The serum levels of miR-210 and HIF-la were significantly increased in the AIS patients at 3 and 7 d after treatment than those before(P<0.05),with the.miR-210 level at 7 d obviously higher than that at 3 d,and the HIF-1α level at 7 d notably lower than that at 3 d(P<0.05).Spearman correlation analysis revealed a negative correlation between pre-treatment serum miR-210 level and prognosis(r=-0.271,P<0.05),while a positive correla-tion between pre-treatment serum HIF-1α level and prognosis(r=0.398,P<0.05).The expres-sion levels of miR-210 and HIF-lawere significantly higher in the poor prognosis group than the good prognosis group(P<0.01).ROC curve analysis indicated that the AUC value of miR-210 and HIF-1α in predicting prognosis was 0.818 and 0.815,with a specificity of 0.850 and 0.700,and a sensitivity of 0.800 and 0.800,respectively,and the AUC value of the two indicators combined together was 0.880,and the sensitivity was 0.900,significantly better than the single indicator(P<0.01).Conclusion Post-treatment serum miR-210 and HIF-1α levels are closely related to mRS.score in AIS patients.Their combined detection can improve the predictive accuracy for prognosis.
作者
程江江
梅利
孙娟
郭雪娟
Cheng Jiangjiang;Mei Li;Sun Juan;Guo Xuejuan(Department of Neurology,Affiliated Hospital of Qinghai University,Xining 810000,Qinghai Province,China)
出处
《中华老年心脑血管病杂志》
北大核心
2025年第6期779-782,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
西宁市科技计划项目(2023-M-20)。
关键词
微RNAS
脑梗死
预后
缺氧诱导因子1Α
microRNAs
brain infarction
prognosis
hypoxia inducible factor-1α
