摘要
目的研究脑梗死患者血清微小RNA-124(miR-124)、同型半胱氨酸(homocysteine,Hcy)、脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)的变化情况及其与患者病情严重程度的关系。方法回顾性分析新乡医学院第三附属医院156例脑梗死患者(研究组)的资料,取同期160例健康体检者作为对照组。比较两组患者血清miR-124、Hcy、Lp-PLA2水平的差异;采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分评估病情严重程度,将患者分为轻、中、重度组,比较不同组别间血清学指标的差异。分析血清miR-124、Hcy、Lp-PLA2水平与脑梗死患者病情严重程度之间的相关性。最后,根据患者随访1年内的预后,将患者分为预后良好组与预后不良组,比较临床资料和血清指标的差异。采用受试者工作特征(ROC)曲线分析miR-124、Hcy、LpPLA2对患者预后的预测价值。结果研究组血清miR-124、Hcy、Lp-PLA2水平高于对照组(P<0.05),轻度组低于中、重度组(P<0.05),中度组低于重度组(P<0.05)。Spearman相关性分析显示,miR-124、Hcy、Lp-PLA2水平与患者病情严重程度呈正相关(P<0.05);预后不良组的梗死面积>20 cm2、多支病变占比、入院时NIHSS评分、血清指标均高于预后良好组(P<0.05);通过ROC曲线分析可知,血清miR-124、Hcy、Lp-PLA2在单独预测以及联合预测脑梗死患者预后时,其灵敏度分别达到69.56%、80.43%、80.43%、91.30%,特异度分别为70.91%、68.18%、70.91%、65.45%,曲线下面积(AUC)分别为0.676、0.782、0.828、0.910,该结果提示联合应用miR-124、Hcy和Lp-PLA2对预后的预测价值更高。结论脑梗死患者血清miR-124、Hcy、Lp-PLA2水平随病情加重呈显著升高趋势,联合这3项指标能较好地预测患者预后。
Objective To study the changes of serum microRNA-124(miR-124),homocysteine(Hcy)and lipoproteinassociated phospholipase A2(Lp-PLA2)in patients with cerebral infarction and analyze their relationship with disease severity.Methods The data of 156 patients with cerebral infarction(study group)in the Third Affiliated Hospital of Xinxiang Medical University were retrospectively analyzed,and 160 healthy people with physical examination were selected as control group.The severity of the condition was assessed using the National Institutes of Health Stroke Scale(NIHSS)score,and patients were divided into mild,moderate,and severe groups.The differences in serological indicators among different groups were compared.Spearman correlation analysis was conducted to analyze the relationship between serum miR-124,Hcy and Lp-PLA2 levels and the severity of cerebral infarction.According to the prognosis status within 1 year of follow-up,participants were stratified into good prognosis and poor prognosis groups,and the differences in clinical data and serum indicators were compared.Receiver operating characteristic(ROC)curve analysis was employed to assess the predictive value of miR-124,Hcy and Lp-PLA2 on prognosis.Results The levels of serum miR-124,Hcy and Lp-PLA2 in study group were higher than those in control group(P<0.05),and the above levels were lower in mild group than those in moderate and severe groups(P<0.05),and were lower in moderate group than those in severe group(P<0.05).Spearman correlation analysis showed that serum miR-124,Hcy and Lp-PLA2 were positively correlated with disease severity(P<0.05).The proportion of infarction size>20cm2,proportion of multivessel lesions,NIHSS score at admission and serum indicators in poor prognosis group were higher than those in good prognosis group(P<0.05).ROC curve analysis showed that the sensitivities of serum miR-124,Hcy,Lp-PLA2 alone and in combination in predicting the prognosis of patients with cerebral infarction were 69.56%,80.43%,80.43%and 91.30%,and the specificities were 70.91%,68.18%,70.91%and 65.45%,and the areas under the curves(ACUs)were 0.676,0.782,0.828 and 0.910 respectively,which indicated that the combination of miR-124,Hcy and Lp-PLA2 had higher predictive value on prognosis.Conclusions The levels of serum miR-124,Hcy and Lp-PLA2 in patients with cerebral infarction increase significantly with the aggravation of disease,and combination of the above three indicators can better predict the prognosis of patients.
作者
刘亚美
李静
宋净洋
郑婷华
郭兆红
LIU Yamei;LI Jing;SONG Jingyang;ZHENG Tinghua;GUO Zhaohong(Department of Neurology,The Third Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453000,China;School of Health and Welfare Management,Xinxiang Medical University,Xinxiang,Henan 453000,China)
出处
《中华神经外科疾病研究杂志》
2025年第5期81-85,共5页
Chinese Journal of Neurosurgical Disease Research
基金
河南省科学技术项目(2023SJGLX240Y)。
