血清微小RNA-92a、微小RNA-34a、微小RNA-181c水平对急性脑梗死诊断及预后评估有重要价值

杨仕良.血清微小RNA-92a、微小RNA-34a、微小RNA-181c水平对急性脑梗死诊断及预后评估有重要价值[J].内科急危重症杂志,2023,29(1):41-45

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DOI：10.11768/nkjwzzzz20230111

中文关键词: 急性脑梗死血清miR-92a miR-34a miR-181c 诊断预后评估

英文关键词:

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作者	单位	E-mail
杨仕良	梧州市人民医院	ke05712@21cn.com

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中文摘要:

摘要目的：探究血清微小RNA-92a（miR-92a）、miR-34a、miR-181c诊断急性脑梗死（ACI）的价值，并分析各指标评估患者预后的临床意义。方法：选取ACI患者80例为研究组，另选取同期健康体检者80例为对照组。比较2组血清miR-92a、miR-34a、miR-181c水平，并比较研究组不同病情患者血清miR-92a、miR-34a、miR-181c水平，分析各指标与神经功能缺损程度、梗死体积的相关性，及对ACI的诊断价值，分析各指标对预后的评估价值。结果：研究组血清miR-92a、miR-34a、miR-181c水平高于对照组（P均＜0.05）；重度、中度和轻度神经功能缺损患者血清miR-92a、miR-34a、miR-181c水平依次降低（P均＜0.05）；梗死体积＞10cm3、5～10cm3、＜5cm3患者血清miR-92a、miR-34a、miR-181c水平依次降低（P均＜0.05）；ACI患者血清miR-92a、miR-34a、miR-181c水平与美国国立卫生研究院卒中量表（NIHSS）评分、梗死体积呈正相关（r=0.857、0.832；0.823、0.806；0.794、0.752，P均＜0.05）；血清miR-92a、miR-34a、miR-181c诊断ACI的曲线下面积（AUC）均＞0.75，具有一定诊断效能，各指标联合诊断的AUC最大（0.927），最佳诊断敏感度、特异性分别为77.50%、95.00%；血清miR-92a、miR-34a、miR-181c阳性患者预后良好率（62.75%、65.52%、62.26%）低于阴性患者（89.66%、90.91%、92.59%，P均＜0.05）。结论：联合检测血清miR-92a、miR-34a、miR-181c水平可辅助临床诊断ACI，且各指标表达水平与患者预后密切相关。

英文摘要:

Abstract Objective: To explore the diagnostic value of serum microRNA-92a (miR-92a), miR-34a, and miR-181c in acute cerebral infarction (ACI), and to analyze the clinical significance of each index to evaluate the prognosis of patients. Methods A total of 80 patients with ACI were selected as the study group, and 80 volunteers undergoing healthy physical examination during the same period were selected as the control group. The serum levels of miR-92a, miR-34a and miR-181c in the two groups were compared, and the serum levels of miR-92a, miR-34a and miR-181c in the study group were compared. The correlation between each index and the degree of neurological deficit and infarct volume and the diagnostic value of ACI was analyzed. The prognostic value of each indicator was analyzed. Results: The serum levels of miR-92a, miR-34a and miR-181c in the study group were higher than those in the control group (P< 0.05). The serum levels of miR-92a, miR-34a and miR-181c in patients with severe, moderate and mild neurological deficits decreased sequentially (all P< 0.05). The serum miR-92a, miR-34a and miR-181c levels in patients with the infarct volume of > 10cm3, 5-10cm3, <5cm3 decreased sequentially (all P< 0.05). The serum levels of miR-92a, miR-34a and miR-181c in patients with ACI were positively correlated with the National Institutes of Health Stroke Scale (NIHSS) score and infarct volume (r=0.857, 0.832; 0.823, 0.806; 0.794, 0.752, P< 0.05). The area under the curve (AUC) of serum miR-92a, miR-34a and miR-181c for the diagnosis of ACI was > 0.75, which had certain diagnostic efficiency, and the AUC of the combined diagnosis of each index was the largest (0.927), and the optimal diagnostic sensitivity and specificity were 77.50% and 95.00%, respectively. The prognosis rate of positive patients with serum miR-92a, miR-34a, and miR-181c (62.75%, 65.52%, 62.26%) was lower than that of negative patients (89.66%, 90.91%, 92.59%, and P< 0.05). Conclusion: Combined detection of serum miR-92a, miR34a, and miR-181c levels can assist clinical diagnosis of ACI, and the expression levels of each index are closely related to the prognosis of patients.