摘要
目的探究血浆微小RNA(microRNA,miR)-497-5p、miR-331-5p与缺血性脑卒中(ischemic stroke,IS)患者神经功能缺损程度及脑卒中后抑郁(post stroke depression,PSD)的相关性。方法选取2021年7月至2023年7月于南阳医学高等专科学校第一附属医院就诊的IS患者191例作为研究组,另选取同期健康体检者191例作为对照组。根据美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)分为轻型缺损组82例、中型缺损组68例和重型缺损组41例。根据汉密尔顿抑郁量表分为非PSD组112例和PSD组79例。Pearson相关性分析、Spearman相关性分析血浆miR-497-5p、miR-331-5p与NIHSS评分的相关性,采用多因素logistic回归分析IS患者发生PSD的危险因素,采用ROC曲线分析血浆miR-497-5p、miR-331-5p水平对IS患者发生PSD的预测价值。结果研究组血浆miR-497-5p、miR-331-5p水平显著高于对照组(P<0.01)。轻型缺损组、中型缺损组和重型缺损组血浆miR-497-5p、miR-331-5p水平和NIHSS评分依次显著升高,3组比较,差异有统计学意义(P<0.01)。miR-497-5p、miR-331-5p与NIHSS评分均呈正相关(P<0.01)。PSD组重型缺损、miR-497-5p、miR-331-5p水平显著高于非PSD组(P<0.01)。多因素logistic回归分析显示,miR-497-5p、miR-331-5p、重型缺损为IS患者发生PSD的危险因素(OR=3.248,95%CI:1.623~6.501;OR=4.258,95%CI:1.739~10.428;OR=2.261,95%CI:1.261~4.055)。血浆miR-497-5p预测IS患者发生PSD的曲线下面积(area under curve,AUC)为0.836,血浆miR-331-5p预测IS患者发生PSD的AUC为0.817,二者联合预测IS患者发生PSD的AUC为0.911,显著优于单独预测(P<0.05)。结论IS患者血浆miR-497-5p、miR-331-5p水平显著升高,与神经功能缺损程度及PSD发生情况密切相关,二者联合对IS患者发生PSD的预测价值较好。
Objective To investigate the correlation between plasma miR-497-5p and miR-331-5p levels and the severity of neurological deficit and incidence of post-stroke depression(PSD)in patients with ischemic stroke(IS).Methods A total of 191 IS patients attended to the First Affiliated Hospital of Nanyang Medical College from July 2021 to July 2023 were enrolled as the study group,and another 191 healthy individuals who taking physical examination in the same period were recruited as the control group.According to the NIHSS score,the patients were divided into mild,moderate and severe neurological deficit subgroups(82,68 and 41 cases,respectively),while according to the results of Hamilton Depression Scale,112 cases were assigned into a non-PSD subgroup and 79 cases into a PSD subgroup.Pearson and Spearman correlation analyses were used to analyze the correlation between plasma miR-497-5p and miR-331-5p levels and NIHSS score.Multivariate logistic regression analysis was employed to identify the risk factors for the occurrence of PSD in IS patients,and ROC curve was plotted to evaluate the predictive values of plasma miR-497-5p and miR-331-5p levels for the occurrence of PSD in IS patients.Results The plasma miR-497-5p and miR-331-5p levels were significantly higher in the study group than the control group(P<0.01).The levels and NIHSS score were significantly increase in the mild,moderate and severe neurological deficit subgroups in order(P<0.01).The two levels and NIHSS score were all positively correlated(P<0.01).The PSD group had more severe deficiency,and higher levels of miR-497-5p and miR-331-5p than the non-PSD group(P<0.01).Multivariate logistic regression analysis showed,the plasma miR-497-5p and miR-331-5p levels and severe deficiency were risk factors for the occurrence of PSD in IS patients(OR=3.248,95%CI:1.623-6.501;OR=4.258,95%CI:1.739-10.428;OR=2.261,95%CI:1.261-4.055).The AUC value of miR-497-5p,miR-331-5p and their combined together for predicting the occurrence of PSD in IS patients was 0.836,0.817 and 0.911,respectively,with the value of combined indicators was superior to that of single one(P<0.05).Conclusion Plasma miR-497-5p and miR-331-5p levels are significantly elevated in IS patients,which are closely associated with the severity of neurological deficits and the occurrence of PSD.Their combination shows a good predictive value for the occurrence of PSD in IS patients.
作者
汤韬
陈敏
姚尚莹
宋彦
Tang Tao;Chen Min;Yao Shangying;Song Yan(First Ward of Neurological Department,First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2024年第8期911-915,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
河南省医学科技攻关计划(联合共建)项目(LHGJ20191467)。
关键词
卒中
神经病学表现
抑郁
预测
循环微RNA
stroke
neurologic manifestations
depression
forecasting
circulating microRNA
