| 刘相城,付宏,刘春柏,等.结合外周血微 RNA-181b表达水平探讨急性脑梗死病人侧支循环形成的影响因素[J].安徽医药,2024,28(3):602-607. |
| 结合外周血微 RNA-181b表达水平探讨急性脑梗死病人侧支循环形成的影响因素 |
| Exploring the influencing factors of collateral circulation in patients with acute cerebral infarction combined with the expression level of miR-181b in peripheral blood |
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| DOI：10.3969/j.issn.1009-6469.2024.03.039 |
| 中文关键词: 脑梗死 微 RNA-181b 侧支循环 血同型半胱氨酸 后循环病变 影响因素 |
| 英文关键词: Cerebral infarction MiR-181b Collateral circulation Homocysteine Posterior circulation lesion Influencing factors |
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| 摘要点击次数: 188 |
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| 中文摘要: |
| 目的结合外周血微 RNA(miR)-181b表达水平探讨急性脑梗死病人侧支循环形成的影响因素。方法选择 2015年 6月至 2019年 5月在深圳市龙华区中心医院住院治疗的 ACI病人 175例，采用计算机产生随机数按 3∶1的比例将纳入病人分为训练集( 129例)和测试集( 46例)其中 129例训练集病人根据侧支循环形成情况分为两组，其中侧支循环良好组病人 90例，支循环不良组病人 39例，采用定量，逆转录 PCR(RT-qPCR)检测血清 miR-181b表达水平，采用 Spearman相关法分析 ACI病人血侧清 miR-181b表达与侧支循环形成的相关性，采用 logistic回归法分析 ACI病人侧支循环形成不良的影响因素，并建立预测模型。结果侧支循环良好组病人血清 miR-181b表达 1.92±0.19显著高于侧支循环形成不良组 1.48±0.26(P<0.05)Spearman相关性分析结果表明，血清 miR-181b表达与侧支循环形成呈显著正相关关系( r=0.77，P<0.001)。 logistic回归分析结果，表明高血压病史高血压史、血同型半胱氨酸( Hcy)、后循环病变均为 ACI病人侧支循环形成不良的独立危险因素( P<0.05)； miR-181b表达水平和脑血管狭窄程度为侧支循环形成不良的保护因素( P<0.05)。基于侧支循环形成不良的影响因素构建预测模型:预测值=EXP［0.491.1.914(高血压史) .1.409(Hcy)+2.145(miR-181b相对表达量) .1.286(后循环病变) +0.594(脑血管狭窄程度)］ /1+EXP［0.491.1.914(高血压史) .1.409(Hcy)+2.145(miR-181b相对表达量) .1.286(后循环病变) .0.594(脑血管狭窄)］。结论侧支循环良好 ACI病人外周血血清 miR-181b表达水平较高，脑血管狭窄程度轻和高水平 miR-181b为侧支循环形成不良的保护因素，而高血压史、 Hcy、后循环病变均为 ACI病人侧支循环形成不良的独立危险因素。 |
| 英文摘要: |
| Objective To explore the influencing factors of collateral circulation formation in patients with acute cerebral infarction(ACI) combined with the expression level of MicroRNA (miR)-181b in peripheral blood.Methods One hundred and seventy-five ACI patients hospitalized in Shenzhen Longhua Central Hospital from June 2015 to May 2019 were selected and randomly assigned intotraining set (129 cases) and test set (46 cases) by computer according to the ratio of 3:1. Among them, 129 patients in training set wereassigned into two groups according to the formation of collateral circulation, including 90 patients in good collateral circulation groupand 39 patients in poor collateral circulation group. The expression level of serum miR-181b was detected by real-time fluorescence quantitative PCR, the correlation between the expression of serum miR-181b and the formation of collateral circulation in ACI patientswas analyzed by Spearman correlation method, and the influencing factors of adverse collateral circulation in ACI patients were ana.lyzed by logistic regression method, and a prediction model was established.Results The expression of miR-181b in good collateralcirculation group (1.92±0.19) was significantly higher than that in poor collateral circulation group (1.48±0.26). Spearman correlationanalysis showed that serum miR-181b expression was significantly positively correlated with the formation of collateral circulation (r= 0.77, P<0.001). Logistic regression analysis indicated that the history of hypertension, Homocysteine (Hcy) and posterior circulation le.sions were independent risk factors for poor collateral circulation in ACI patients (P<0.05), while the expression level of miR-181b and the degree of cerebrovascular stenosis were protective factors for the formation of poor collateral circulation (P<0.05). The predictionmodel was constructed based on the influencing factors of poor collateral circulation, the predictive value was EXP [0.491.1.914 (histo.ry of hypertension) . 1.409 (Hcy) + 2.145 (relative expression of miR-181b) . 1.286 (posterior circulation lesions) + 0.594 (degree of cerebral vascular stenosis)] / 1 + EXP [0.491-1.914 (history of hypertension) . 1.409 (Hcy) + 2.145 (relative expression of miR-181b) . 1.286 (posterior circulation diseases)] . 0.594 (cerebral vascular stenosis)].Conclusions The expression level of miR-181b in periph. eral blood serum of ACI patients with good collateral circulation is high. The high expression of miR-181b and the mild degree of cere.brovascular stenosis are protective factors for the formation of poor collateral circulation, while the history of hypertension, Hcy and pos.terior circulation lesions are independent risk factors for the formation of poor collateral circulation in ACI patients. |
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