李津.血清lncRNA XIST、miR-15b异常表达增加急性脑梗死发生风险[J].内科急危重症杂志,2024,30(6):545-549
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| DOI：10.11768/nkjwzzzz.20240613 |
| 中文关键词: 血清长链非编码RNAX染色体失活特异转录本 微小RNA-15b 急性脑梗死 相关性 |
| 英文关键词: |
| 基金项目:保定市科学技术研究与发展计划项目（2141ZF085） |
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| 中文摘要: |
| 摘要 目的：探讨血清长链非编码RNA（lncRNA）X染色体失活特异性转录本（XIST）、微小RNA-15b（miR-15b）表达与急性脑梗死（ACI）发生风险的相关性。方法：选取146例经头颅磁共振（MRI）确诊为ACI的患者为观察组，选取同期健康体检者80例为对照组。入院时，采用美国国立卫生院神经功能缺损评分量表（NIHSS）对ACI患者进行神经功能缺损评分，根据NHISS评分将其分为轻度组74例、中度组46例、重度组26例。采用实时荧光定量PCR检测入院时血清lncRNA XIST、miR-15b表达，分析其表达与ACI发生风险的关系。结果：观察组患者血清lncRNA XIST表达量显著低于对照组，其中重度组低于中度组和轻度组，且中度组低于轻度组；血清miR-15b表达量显著高于对照组，其中重度组高于中度组和轻度组，且中度组高于轻度组（P均＜0.05）。Pearson相关性分析显示，血清lncRNA XIST表达与NIHSS评分呈负相关（r=-0.467，P<0.001）；血清miR-15b表达与NIHSS评分呈正相关（r=0.526，P<0.001）。血清lncRNA XIST、miR-15b高表达和低表达患者脑梗死范围、牛津郡社区卒中计划（OCSP）分型、血脂异常的患者比例比较，差异有统计学意义（P均＜0.05）。多因素logistic回归分析显示，血脂异常（OR=3.380，95%CI：1.338～8.543）、血清lncRNA XIST（OR=7.576，95%CI：4.110～13.965）、血清miR-15b（OR=8.449，95%CI：5.085～14.036）是影响ACI发生的独立危险因素（P均＜0.05）。受试者工作特征（ROC）曲线结果显示，血清lncRNA XIST表达为0.72时，预测ACI发生风险的ROC曲线下面积（AUC）为0.74（95%CI：2.354～4.212），敏感度为77.42%，特异性为70.35%；血清miR-15b表达为1.35时，预测ACI发生风险AUC为0.71（95%CI：1.479～3.268），敏感度为74.29%，特异性为69.35%；两者联合检测预测ACI发生风险AUC为0.78（95%CI：2.527～4.136），敏感度为79.46%，特异性为71.38%。结论：血清lncRNA XIST、miR-15b表达与ACI患者神经功能缺损程度密切相关，血清lncRNA XIST表达下调、miR-15b表达上调是发生ACI的独立危险因素，两者联合检测对预测ACI发生有一定参考价值。 |
| 英文摘要: |
| Abstract Objective: To investigate the correlation between the expression of long non-coding RNA (lncRNA) X chromosome inactivation specific transcript (XIST) and micrornA-15b (miR-15b) in serum and the risk of acute cerebral infarction. Methods: A total of 146 patients diagnosed with acute cerebral infarction (ACI) by head magnetic resonance imaging (MRI) were selected as the observation group, and 80 healthy subjects with no abnormal physical examination during the same period were selected as the control group. At admission, the neurological impairment Scale (NIHSS) of the National Institutes of Health was used to score the neurological impairment of ACI patients. According to the severity of neurological impairment, ACI patients were divided into a mild group (74 cases), a moderate group (46 cases), and a severe group (26 cases). Serum was collected upon admission, and the expression of serum lncRNA XIST and miR-15b was detected by real-time fluorescent quantitative PCR, and the relationship between their expression and the risk of ACI disease was analyzed. Result: The expression level of serum IncRNA XIST in observation group was significantly lower than that in control group, that in severe group was lower than moderate group and mild group, and that in moderate group was lower than mild group; Serum miR-15b expression level was significantly higher than that of control group, among which severe group was higher than moderate group and mild group, and moderate group was higher than mild group (all P <0.05). According to Pearson correlation analysis, serum lncRNA XIST expression was negatively correlated with NIHSS score (r=-0.467, P<0.001). Serum miR-15b expression was positively correlated with NIHSS score (r=0.526, P<0.001). There were statistically significant differences between patients with high and low expression of serum lncRNA XIST and miR-15b in the scope of cerebral infarction, the type of Oxfordshire Community Stroke Project (OCSP), and dyslipidemia (all P< 0.05). Multivariate logistic regression analysis showed that dyslipidemia (OR=3.380, 95%CI: 1.338-8.543), serum lncRNA XIST (OR=7.576, 95%CI: 4.110-13.965), serum miR-15b (OR=8.449, 95%CI: 5.085-14.036) were independent risk factors for ACI disease occurrence (all P< 0.05). Receiver operating characteristic (ROC) curve results showed that when serum lncRNA XIST expression was 0.72, the area under ROC curve (AUC) for predicting the risk of ACI disease was 0.74 (95%CI: 2.354-4.212), and the sensitivity and specificity were 77.42% and 70.35% respectively. When serum miR-15b expression was 1.35, the predicted risk of ACI disease was 0.71 (95%CI: 1.479-3.268), and the sensitivity and specificity were 74.29% and 69.35% respectively. The combined detection predicted the risk of ACI disease with an AUC of 0.78 (95%CI: 2.527-4.136), sensitivity and specificity of 79.46% and 71.38% respectively. Conclusion: Serum lncRNA XIST and miR-15b expressions are closely related to the degree of neurological impairment in ACI patients. The down-regulation of serum lncRNA XIST expression and up-regulation of miR-15b expression levels are independent risk factors for the risk of ACI disease, and the combined detection of the two has certain reference value for predicting the occurrence of ACI disease. |
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