摘要
目的探讨急性脑梗死介入治疗前后微小核糖核酸(miR)-200c与miR133b-3p的变化及与预后的关系。方法选取2022年5月—2024年5月南京医科大学附属明基医院接诊的急性脑梗死患者124例,记录患者介入术后3个月的治疗结局,分为预后良好组和预后不良组,比较两组患者介入治疗前后miR-200c、miR133b-3p水平差异,采用多因素Logistic回归分析急性脑梗死患者不良预后的危险因素,绘制受试者操作特征(ROC)曲线评估miR-200c、miR133b-3p对急性脑梗死患者不良预后的预测价值。结果术后3个月,124例行介入治疗的急性脑梗死患者中预后不良36例(29.03%),预后良好88例(70.97%)。预后不良组和预后良好组的美国国立卫生研究院卒中量表(NIHSS)评分分别为(15.41±1.93)分vs(.13.01±1.85)分,低密度脂蛋白胆固醇(LDLC)分别为(3.29±0.93)mmol/L vs(.2.85±0.98)mmol/L,中枢神经特异性蛋白β(S100β)分别为(1.49±0.35)μg/L vs.(1.02±0.41)μg/L,△miR-200c分别为(0.67±0.25)vs.(1.14±0.31),△miR133b-3p分别为(0.74±0.35)vs.(1.69±0.51),差异均有统计学意义(t=6.476、2.302、6.034、8.079、10.223,均P<0.05)。NIHSS评分(OR=4.509,95%CI:1.957~10.386)、LDL-C(OR=4.104,95%CI:1.781~9.455)、S100β(OR=4.183,95%CI:1.815~9.636)是急性脑梗死患者预后不良的危险因素(均P<0.05),△miR-200c(OR=0.232,95%CI:0.101~0.536)、△miR133b-3p(OR=0.223,95%CI:0.097~0.531)是急性脑梗死患者预后不良的保护因素(均P<0.05)。△miR-200c、△miR133b-3p单一及联合预测急性脑梗死患者预后不良的灵敏度分别为0.76、0.78、0.90,特异度分别为0.79、0.70、0.70,曲线下面积分别为0.751(95%CI:0.648~0.853)、0.746(95%CI:0.635~0.841)、0.843(95%CI:0.765~0.925)。结论△miR-200c、△miR133b-3p可用于预测急性脑梗死患者的预后,预测效能良好。
Objective To explore the relationship between changes in microRNA(miR)-200c and miR133b-3p levels and prognosis before and after interventional treatment for acute cerebral infarction.Methods One hundred and twenty-four patients with acute cerebral infarction admitted to BenQ Medical Hospital Affiliated to Nanjing Medical University from May 2022 to May 2024 were selected,and their treatment outcomes were recorded 3 months after intervention.They were divided into a good prognosis group and a poor prognosis group.The differences in miR-200c and miR133b-3p levels before and after intervention treatment were compared between the two groups of patients,and the risk factors for poor prognosis in acute cerebral infarction patients were analyzed.The predictive value of miR-200c and miR133b-3p for poor prognosis in acute cerebral infarction patients was evaluated.Results Three months after surgery,among 124 patients with acute cerebral infarction who underwent interventional treatment,36(29.03%)had poor prognosis and 88(70.97%)had good prognosis.The NIHSS scores of the poor prognosis group and the good prognosis group were(15.41±1.93)and(13.01±1.85)points,LDL-C were(3.29±0.93)and(2.85±0.98)mmol/L,S100βwas(1.49±0.35)and(1.02±0.41)μg/L,ΔmiR-200c was(0.67±0.25)and(1.14±0.31),ΔmiR133b-3p was(0.74±0.35)and(1.69±0.51),respectively,and the differences were statistically significant(t=6.476,2.302,6.034,8.079,10.223,all P<0.05).NIHSS score(OR=4.509,95%CI:1.957-10.386),LDL-C(OR=4.104,95%CI:1.781-9.455),S100β(OR=4.183,95%CI:1.815-9.636)were risk factors for poor prognosis in patients with acute cerebral infarction(all P<0.05),while△miR-200c(OR=0.232,95%CI:0.101-0.536)and△miR133b-3p(OR=0.223,95%CI:0.097-0.531)were protective factors for prognosis in patients with acute cerebral infarction(both P<0.05).The sensitivity and specificity ofΔmiR-200c andΔmiR133b-3p for poor prognosis in patients with single and combined acute cerebral infarction were 0.76,0.78,and 0.90,respectively,and 0.79,0.70,and 0.70,respectively.The area under the curve was 0.751(95%CI:0.648-0.853),0.746(95%CI:0.635-0.841),and0.843(95%CI:0.765-0.925),respectively.Conclusion△miR-200c and△miR133b-3p can be used to predict the prognosis of patients with acute cerebral infarction,with good predictive efficacy.
作者
胡燕
苗燕
刚书成
HU Yan;MIAO Yan;GANG Shucheng(Department of Neurology,the Affiliated BenQ Hospital of Nanjing Medical University,Nanjing Jiangsu 210019,China)
出处
《中国急救复苏与灾害医学杂志》
2025年第11期1472-1476,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
江苏省科技计划项目-青年基金项目(BK20210087)。
关键词
急性脑梗死
介入治疗
预后
危险因素
Acute cerebral infarction
Intervention treatment
Prognosis
Risk factors
