摘要
目的 探讨miR-27-3p、miR-128-3p及miR-140-3p表达在急性脑梗死(ACI)患者诊疗中的应用价值。方法 选取2020年1月至2022年12月南通市第三人民医院全科医学科收治的ACI患者100例作为研究对象,定义为ACI组,根据ACI患者3个月改良Rankin评分量表(mRS评分)将其分为预后良好组(mRS评分≤2分)68例与预后不良组(mRS>2分)32例,另选同期于南通市第三人民医院全科医学科体检的健康者100例作为对照组。记录各组miR-27-3p、miR-128-3p及miR-140-3p表达水平并进行比较,采用Pearson相关分析探讨两变量的相关性,通过绘制受试者工作特征(ROC)曲线评价miR-27-3p、miR-128-3p及miR-140-3p联合检测在ACI诊断中的效能,采用多因素Logistic回归分析探讨ACI预后的危险因素。结果 ACI组平均年龄、吸烟史比例、合并高血压比例、miR-140-3p与miR-128-3p及miR-27-3p表达水平均明显高于对照组(均P<0.05)。miR-27-3p、miR-128-3p及miR-140-3p联合检测用于诊断ACI的曲线下面积(AUC值)为0.965,敏感度为99.00%,特异度为98.00%,表明miR-27-3p、miR-128-3p及miR-140-3p联合检测用于诊断ACI的效能更高。预后不良组平均年龄、入院时NIHSS评分、梗死体积、吸烟史比例、合并高血压比例、miR-27-3p、miR-128-3p、miR-140-3p表达水平及3个月mRS评分均明显高于预后良好组(均P<0.05)。经Pearson相关分析表明ACI患者miR-27-3p、miR-128-3p、miR-140-3p表达水平均分别与入院时NIHSS评分、梗死体积、3个月mRS评分呈正相关(均P<0.05)。经多因素Logistic回归分析表明年龄(OR:1.546;95%CI:1.124~1.969)、入院时NIHSS评分(OR:1.721;95%CI:1.229~2.308)、梗死体积(OR:1.853;95%CI:1.436~2.786)、吸烟史(OR:1.517;95%CI:1.168~1.825)、miR-27-3p (OR:2.481;95%CI:1.452~3.201)、miR-128-3p (OR:1.692;95%CI:1.288-2.431)及miR-140-3p (OR:2.032;95%CI:1.141~1.976)均为ACI患者预后的独立危险因素(均P<0.05)。结论 ACI患者miR-27-3p、miR-128-3p及miR-140-3p表达水平均明显升高,通过三指标联合检测可提高对ACI的诊断效能,而预后不良ACI患者miR-27-3p、miR-128-3p及miR-140-3p表达水平则升高更为明显,并分别与入院时NIHSS评分、梗死体积、3个月mRS评分呈正相关,且miR-27-3p、miR-128-3p及miR-140-3p均为ACI患者预后的独立危险因素,应予以重点关注。
Objective To discuss the application value of miR-27-3p,miR-128-3p and miR-140-3p expression in the diagnosis and treatment of patients with acute cerebral infarction(ACI).Methods 100 ACI patients admitted to the Department of General Medicine,Nantong Third People's Hospital from Jan 2020 to Dec 2022 were selected as the as ACI group,then divided into the good prognosis group(mRS score≤2)68 cases and the poor prognosis group(mRS score>2)32 cases according to the three-month modified Rankin scale(mRS score);In addition,100 healthy people who examined in the Department of General Medicine,Nantong Third People's Hospital at the same time were served as the control group.The miR-27-3p,miR-128-3p and miR-140-3p expression levels of each group were recorded and compared;the Pearson correlation analysis was used to explore the correlation between the two variables;the efficacy of miR-27-3p,miR-128-3p and miR-140-3p combined detection in the diagnosis of ACI was evaluated by drawing the receiver operating characteristic(ROC)curve;the Multifactor logistic regression analysis was used to explore the risk factors for the prognosis of ACI.Results The average age,the proportion of smoking history,the proportion of hypertension,the expression of miR-140-3p,miR-128-3p and miR-27-3p of the ACI group were significantly higher than the control group(l"P<0.05).The area under the curve(AUC value)of miR-27-3p,miR-128-3p and miR-140-3p combined detection for diagnosis of ACI was 0.965,the sensitivity was 99.00%and the specificity was 98.00%,which indicating that the combined detection of miR-27-3p,miR-128-3p and miR-140-3p was more effective for diagnosis of ACI.The mean age,NIHSS score at admission,infarct volume,proportion of smoking history,proportion of hypertension,miR-27-3p,miR-128-3p,miR-140-3p expression level and 3-month mRS score of the poor prognosis group were significantly higher than the good prognosis group(P<0.05).The pearson correlation analysis showed that the expression levels of miR-27-3p,miR-128-3p and miR-140-3p of ACI patients were positively correlated with the NIHSS score at admission,infarct volume and 3-month mRS score(P<0.05).The Multivariate Logistic regression analysis showed that age(OR:1.546;95%CI:1.124-1.969),NIHSS score at admission(OR:1.721;95%CI:1.229-2.308),infarction volume(OR:1.853;95%CI:1.436-2.786),smoking history(OR:1.517;95%CI:1.168-1.825),miR-27-3p(OR:2.481;95%CI:1.452-3.201),miR-128-3p(OR:1.692;95%CI:1.288-2.431)and miR-140-3p(OR:2.032;95%CI:1.141-1.976)were independent risk factors for the prognosis of patients with ACI('P<0.05).Conclusion The miR-27-3p,miR-128-3p and miR-140-3p expression levels of ACI patients were significantly increased,and the combined detection of three indicators can improve the diagnostic efficacy of ACI;the miR-27-3p,miR-128-3p and miR-140-3p expression levels of ACI patients with poor prognosis were significantly increased,which were positively correlated with NIHSS score,infarct volume and 3-month mRS score respectively;the miR-27-3p,miR-128-3p and miR-140-3p were independent risk factors for the prognosis of patients with ACI,whch should be focused on.
作者
毛凌云
刘洋
谭政
Mao Lingyun;Liu Yang;Tan Zheng(Department of General Medicine,Nantong Third People's Hospital,Jiangsu 226000,China)
出处
《脑与神经疾病杂志》
2024年第1期39-44,共6页
Journal of Brain and Nervous Diseases
基金
南通市卫生健康委员会科研课题(MB2021056)。
