血清微小RNA-143-3p、微小RNA-188-5p水平对急性脑梗死患者静脉溶栓后预后不良的预测价值

doi:10.3969/j.issn.1006-5725.2025.08.005

Abstract

Abstract:

Objective To investigate the predictive value of serum microRNA （miRNA） -143-3p and miR-188-5p levels for poor prognosis in patients with acute cerebral infarction （ACI） after thrombolysis. Methods From February 2022 to February 2024， 121 patients with acute cerebral infarction （ACI） who visited the hospital （all treated with thrombolysis） were selected as the study group. They were assigned into mild and moderate to severe groups based on the severity of their condition. They were into good prognosis group and poor prognosis group based on their postoperative condition. In addition， another 121 healthy individuals who underwent physical check ups during the same period were as the control group. The qRT-PCR method was applied to detect the expression levels of miR-143-3p and miR-188-5p. Pearson correlation was applied to analyze the correlation between serum miR-143-3p， miR-188-5p and NIHSS score. The influencing factors of poor prognosis in ACI patients after thrombolysis were analyzed using multiple logistic regression. ROC curve was plotted to analyze the predictive value of serum miR-143-3p and miR-188-5p for poor prognosis after thrombolysis in ACI patients. Results The serum miR-143-3p level in the study group was higher than that in the control group （P < 0.05）， and the miR-188-5p level was lower than that in the control group （P < 0.05）； The serum miR-143-3p and NIHSS score in the mild， moderate and severe groups were increased in turn， and the level of miR-188-5p was decreased in turn （P < 0.05）； Serum miR-143-3p was negatively correlated with miR-188-5p （P < 0.05）； Diabetes， time from onset to thrombolysis， NIHSS score at admission， miR-143-3p and miR-143-3p were the influencing factors of poor prognosis in ACI patients after thrombolysis； The AUC of the joint of serum miR-143-3p and miR-188-5p in predicting poor prognosis after thrombolysis in ACI patients was 0.871， and the joint of the two was better than their individual predictions （Z = 2.683， 2.703， P < 0.05）. Conclusions The level of serum miR-143-3p in ACI patients is significantly increased， and the level of serum miR-188-5p is significantly decreased， which is a poor prognostic factor for ACI patients after thrombolysis. The combination of the two has higher diagnostic value.

Key words: microribonucleic acid-143-3p, microribonucleic acid-188-5p, acute cerebral infarction, thrombolysis, poor prognosis, predictive value

CLC Number:

R743.33

Yingdao CHEN,Haining LI,Yuying LI,Qiping ZHANG,Bingsong LIANG,Guohui. LI. The predictive value of serum miR-143-3p and miR-188-5p levels for poor prognosis in patients with acute cerebral infarction after thrombolysis[J]. The Journal of Practical Medicine, 2025, 41(8): 1117-1122.

Figures/Tables 9

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References 25

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项目	正向引物5′-3′	反向引物5′-3′
miR-143-3p	ACCAGCGCATGGACAGT	ACTTGACCACCGAACCC
miR-188-5p	ACCAGCGCATGGACAGTTA	ACTTGACCACCGAACCCAT
U6	CTCGCTTCGGCAGCACA	AACGCTTCACGAATTTGCGT

组别	例数	miR-143-3p	miR-188-5p
对照组	121	1.01 ± 0.29	1.00 ± 0.28
观察组	121	2.29 ± 0.36	0.60 ± 0.16
t值		30.458	13.644
P值		< 0.001	< 0.001

组别	例数	miR-143-3p	miR-188-5p	NIHSS评分/分
轻度组	53	1.65 ± 0.24	0.84 ± 0.21	2.76 ± 0.80
中重度组	68	2.79 ± 0.46^?	0.42 ± 0.21^?	13.94 ± 1.76^?
t值		16.378	10.915	42.891
P值		< 0.001	< 0.001	< 0.001

指标	miR-143-3p		miR-188-5p
指标	r/r_s值	P值	r/r_s值	P值
miR-143-3p	-	-	-0.503	< 0.001
miR-188-5p	-0.503	< 0.001	-	-
NIHSS评分	0.496	< 0.001	-0.486	< 0.001

一般资料	预后良好组（n = 81）	预后不良组（n = 40）	t/χ² 值	P值
年龄/岁	66.28 ± 3.72	66.34 ± 3.85	0.083	0.934
男/女/例	48/33	25/15	0.118	0.732
体质量指数/（kg/m²）	22.50 ± 3.04	22.43 ± 3.11	0.118	0.906
吸烟/［例（%）］	20（24.69）	11（27.50）	0.111	0.739
饮酒/［例（%）］	22（27.16）	13（32.50）	0.371	0.542
高血压/［例（%）］	16（19.75）	9（22.50）	0.123	0.726
糖尿病/［例（%）］	12（14.81）	13（32.50）	5.109	0.024
冠心病/［例（%）］	13（16.05）	8（20.00）	0.291	0.589
心房颤动/［例（%）］	11（13.58）	7（17.50）	0.325	0.569
发病至溶栓时间/min	186.25 ± 35.26	223.68 ± 40.65	5.219	< 0.001
入院时NIHSS评分/［例（%）］			10.047	0.002
≥15分	13（16.05）	17（42.50）
< 15分	68（83.95）	23（57.50）
脑梗死面积/［例（%）］			3.786	0.151
腔隙性	36（44.44）	11（27.50）
中面积	25（30.86）	13（32.50）
大面积	21（25.93）	16（40.00）
梗死部位/［例（%）］			0.039	0.843
前循环	43（53.09）	22（55.00）
后循环	38（46.91）	18（45.00）

The predictive value of serum miR-143-3p and miR-188-5p levels for poor prognosis in patients with acute cerebral infarction after thrombolysis

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组别	例数	miR-143-3p	miR-188-5p	mRS评分/分
预后良好组	81	1.67 ± 0.28	0.80 ± 0.22	1.45 ± 0.37
预后不良组	40	3.56 ± 0.53	0.20 ± 0.04	3.83 ± 0.62
t值		25.704	17.075	26.376
P值		< 0.001	< 0.001	< 0.001

指标	β	SE	Wald χ²	P值	OR	95%CI
miR-143-3p	0.987	0.301	10.759	0.001	2.684	1.488 ~ 4.842
miR-188-5p	-0.472	0.220	4.595	0.032	0.624	0.405 ~ 0.960
糖尿病	1.107	0.413	7.183	0.007	3.025	1.346 ~ 6.796
发病至溶栓时间	1.139	0.436	6.826	0.009	3.124	1.330 ~ 7.342
入院时NIHSS评分	1.392	0.480	11.632	< 0.001	4.021	1.807 ~ 8.946

项目	AUC	95%CI	灵敏度/%	特异度/%	截断值
miR-143-3p	0.830	0.744 ~ 0.916	76.35	77.32	3.246
miR-188-5p	0.822	0.750 ~ 0.894	78.86	76.67	0.304
二者联合	0.871	0.804 ~ 0.938	84.63	74.68	-

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