摘要
目的探讨缺血性卒中后吞咽和认知功能障碍患者血浆miRNA表达水平及其与功能障碍严重程度的相关性。方法回顾性分析2023年1月至2024年3月于广西医科大学第一附属医院、福建医科大学附属第一医院住院的109例缺血性卒中患者临床资料,RT-qPCR检测血浆miR-140-5p、miR-17-5p、miR-103a-3p表达水平,洼田饮水试验和功能性口服摄食量表评估吞咽功能,卒中改良Rankin量表(mRS)分级评估卒中患者认知功能,根据mRS评级标准将患者分为功能结局良好组(分级≤2级,n=50)和功能结局不佳组(分级≥3级,n=59),分析miRNA表达水平与功能障碍程度的相关性,比较不同mRS分级患者临床特征,采用受试者工作特征(ROC)曲线和曲线下面积(AUC)分析miRNA预测mRS评价功能结局的效能。结果Spearman相关性分析结果显示,miR-17-5p表达水平与洼田饮水试验分级(r=-0.317)、功能性口服摄食量表分级(r=-0.457)呈负相关(P<0.05)。与功能结局良好组比较,功能结局不佳组男性比例更低,病程更短,miR-103a-3p表达水平更高,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,miR-103a-3p(AUC=0.709,95%CI:0.611~0.808)对于mRS评价功能结局具有区分能力,而miR-140-5p(AUC=0.514,95%CI:0.405~0.624)、miR-17-5p(AUC=0.527,95%CI:0.414~0.637)不具有区分能力。结论血浆miR-17-5p表达水平与缺血性卒中恢复期患者吞咽功能障碍严重程度有关,miR-103a-3p有助于判断缺血性卒中恢复期患者的功能结局。
Objective To explore the expression level of plasma miRNA in patients with swallowing and cognitive dysfunction after ischemic stroke and its correlation with the severity of dysfunction.Methods A retrospective analysis was conducted on the clinical data of 109 patients with ischemic stroke who were hospitalized in the First Affiliated Hospital of Guangxi Medical University and the First Affiliated Hospital of Fujian Medical University from January 2023 to March 2024.The expression levels of plasma miR-140-5p,miR-17-5p,and miR-103a-3p were detected by RT-qPCR.The swallowing function was evaluated by the Wada Drinking Water Test and the Functional Oral Feeding Scale,and the cognitive function of stroke patients was evaluated by the modified Rankin Scale(mRS)classification.According to the mRS rating criteria,the patients were divided into the good functional outcome group(grade≤2,n=50)and the poor functional outcome group(grade≥3,n=59).Analyzed the correlation between miRNA expression levels and the degree of functional impairment,compared the clinical characteristics of patients with different mRS grades,and used the receiver operating characteristic(ROC)curve and the area under the curve(AUC)to analyze the efficacy of miRNA in predicting the functional outcome of mRS evaluation.Results The results of Spearman correlation analysis showed that the expression level of miR-17-5p was negatively correlated with the classification of the Wada Drinking Water Test(r=-0.317)and the classification of the Functional Oral Feeding Scale(r=-0.457,P<0.05).Compared with the good functional outcome group,the poor functional outcome group had a lower proportion of males,shorter disease course,and higher expression level of miR-103a-3p,the differences were statistically significant(P<0.05).The results of ROC curve analysis showed that miR-103a-3p(AUC=0.709,95%CI:0.611-0.808)had the ability to distinguish functional outcomes in mRS evaluation.However,miR-140-5p(AUC=0.514,95%CI:0.405-0.624)and miR-17-5p(AUC=0.527,95%CI:0.414-0.637)did not have the ability.Conclusion The expression level of plasma miR-17-5p is related to the severity of dysphagia in patients in the recovery period of ischemic stroke,and miR-103a-3p is helpful for judging the functional outcomes of patients in the recovery period of ischemic stroke.
作者
左为峰
陈建敏
潘勤和
姚敬智
桂裕昌
许建文
ZUO Weifeng;CHEN Jianmin;PAN Qinhe;YAO Jingzhi;GUI Yuchang;XU Jianwen(Department of Rehabilitation Medicine,the First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530022,China;Department of Rehabilitation Medicine,the First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian 340004,China)
出处
《重庆医学》
2025年第8期1824-1829,共6页
Chongqing Medical Journal
基金
福建省自然科学基金项目(2024J01520)。
