摘要
目的探索急性缺血性脑卒中(AIS)患者血清微小RNA-140-3p(miR-140-3p)、Krüpple样因子5(KLF5)表达水平与颈动脉斑块稳定性及狭窄程度的相关性。方法选择2022年10月—2024年1月本院收治的285例AIS患者作为研究对象,依据超声结果将患者分为斑块易损组(196例)、斑块稳定组(53例)以及无斑块组(36例);将患者依据斑块狭窄程度分为狭窄重度组(42例)、狭窄中度组(57例)、狭窄轻度组(150例)以及无狭窄组(36例)。收集患者的一般资料,采用实时荧光定量PCR对血清miR-140-3p、KLF5表达水平进行检测;多因素Logistic回归分析AIS患者颈动脉斑块不稳定性的影响因素;受试者工作特征(ROC)曲线分析血清miR-140-3p、KLF5水平检测对AIS患者颈动脉斑块不稳定的诊断价值;分析不同狭窄程度血清miR-140-3p、KLF5水平;Pearson法和Spearman法相关性分析血清miR-140-3p、KLF5水平的相关性及二者与AIS患者颈动脉斑块稳定及狭窄程度的相关性。结果斑块易损组患者高血压人数、糖尿病人数、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(LDL-C)、D-二聚体(D-D)、纤维蛋白原(FIB)、膀抑素C(Cys-C)及KLF5水平高于斑块稳定组及无斑块组(P<0.05),血小板(PLT)及miR-140-3p水平低于斑块稳定组及无斑块组(P<0.05),斑块稳定组LDL-C、FIB、D-D、Cys-C及KLF5水平高于无斑块组(P<0.05),PLT及miR-140-3p水平低于无斑块组(P<0.05);多因素Logistic回归分析显示PLT、D-D、FIB、Cys-C、miR-140-3p、KLF5是AIS患者斑块不稳定性的影响因素(P<0.05);ROC分析显示,miR-140-3p、KLF5联合诊断AIS患者颈动脉斑块不稳定的ROC曲线下面积(AUC)显著大于miR-140-3p单独诊断的AUC(Z=4.617,P<0.001),KLF5单独诊断的AUC(Z=3.473,P=0.001);随着患者狭窄程度的增加,患者血清miR-140-3p水平降低(F=341.819,P<0.001),血清KLF5水平升高(F=152.186,P<0.001);Pearson法相关性分析显示,血清miR-140-3p水平与血清KLF5水平及斑块稳定性、狭窄程度呈负相关(r=-0.536,-0.529,-0.601,P<0.001),血清KLF5水平与斑块稳定性及狭窄程度呈正相关(r=0.511,0.634,P<0.001)。结论AIS患者血清miR-140-3p水平降低,血清KLF5水平升高,其水平变化与颈动脉斑块稳定性及狭窄程度密切相关。
Objective To explore the correlation between the expression levels of serum microRNA-140-3p(miR-140-3p)and Krüpple like factor 5(KLF5)in patients with acute ischemic stroke(AIS)and the stability and stenosis of carotid artery plaques.Methods A study was conducted on 285 AIS patients who were admitted the hospital from October 2022 to January 2024.Based on ultrasound results,the 285 patients were grouped into plaque vulnerable group(196 cases),plaque stable group(53 cases),and non plaque group(36 cases);patients were also grouped into severe stenosis group(42 cases),moderate stenosis group(57 cases),mild stenosis group(150 cases),and no stenosis group(36 cases)based on the degree of plaque stenosis.The general information of the patient was collected,quantitative real-time PCR was applied to detect the expression levels of serum miR-140-3p and KLF5.Multivariate logistic regression was applied to analyze the influencing factors of carotid plaque instability in AIS patients.Receiver operating characteristic curve(ROC)was applied to analyze the diagnostic value of serum miR-140-3p and KLF5 levels detection for carotid plaque instability in AIS patients.The serum levels of miR-140-3p and KLF5 in different degrees of stenosis were analyzed.Pearson and Spearman methods were applied to analyze the correlation between serum miR-140-3p and KLF5 levels,and their correlation with the stability and stenosis degree of carotid plaque in AIS patients.Results The number of hypertension,number of diabetes,levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),D-dimer(D-D),fibrinogen(FIB),cystatin-C(Cys-C)and KLF5 in vulnerable plaque group were higher than those in stable plaque group and non plaque group(P<0.05);platelet(PLT)and miR-140-3p levels were lower than the plaque stable group and non plaque group(P<0.05).LDL-C,FIB,D-D,Cys-C,and KLF5 levels in the plaque stable group were higher than those in the non plaque group(P<0.05),while PLT and miR-140-3p levels in the plaque stable group were lower than those in the non plaque group(P<0.05).Multivariate Logistic regression analysis showed that PLT,D-D,FIB,Cys-C,miR-140-3p,and KLF5 were the influencing factors of plaque instability in AIS patients(P<0.05).ROC analysis showed that the area under curve(AUC)of miR-140-3p combined KLF5 in diagnosing instability of carotid plaques in AIS patients was obviously larger than that diagnosed by miR-140-3p alone(Z=4.617,P<0.001)and KLF5 alone(Z=3.473,P=0.001).As the degree of stenosis increased,the serum miR-140-3p level in patients decreased(F=341.819,P<0.001),while the serum KLF5 level increased(F=152.186,P<0.001).Pearson correlation analysis showed that serum miR-140-3p level was negatively correlated with serum KLF5 level,plaque stability,and stenosis degree(r=-0.536,-0.529,-0.601,P<0.001),while serum KLF5 level was positively correlated with plaque stability and stenosis degree(r=0.511,0.634,P<0.001).Conclusions The serum miR-140-3p level in AIS patients decreases,while the serum KLF5 level increases.The changes are closely related to the stability and stenosis degree of carotid artery plaque.
作者
张静
李宇辉
李芳芳
Zhang Jing;Li Yuhui;Li Fangfang(Department of Neurology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)
出处
《齐齐哈尔医学院学报》
2024年第12期1101-1107,共7页
Journal of Qiqihar Medical University
基金
2019年度河南省医学科技攻关计划联合共建项目(LHGJ20190412)。
作者简介
通信作者:张静,Email:ZJ8989ZJ@163.com。
