标题：血清miR-34a与脑卒中患者rt-PA静脉溶栓后神经功能恢复的相关性

      作者：杨小静，刘倩    宝鸡市人民医院神经内科，陕西 宝鸡 721000

      卷次： 2022年33卷12期

      【摘要】 目的 分析血清miR-34a与脑卒中患者重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后神经功能恢复的相关性。方法 选取2019年12月至2020年12月宝鸡市人民医院神经内科收治的98例行 rt-PA静脉溶栓治疗的脑卒中患者纳入研究组。同时选取来本院健康体检中心体检的健康志愿者62例纳入对照组。检测两组受试者的血清miR-34a水平，并采用改良Rankin量表(mRS)评估两组受试者的神经功能。将研究组患者根据mRS得分分为神经功能恢复良好组和神经功能恢复不良组。采用Logistic回归分析法分析影响脑卒中患者神经功能恢复不良的危险因素。采用Pearson相关性分析法分析血清miR-34a水平与脑卒中患者神经功能恢复的相关性。结果 研究组患者的血清miR-34a水平、mRS评分分别为53.57±10.69、(2.72±0.78)分，明显高于对照组的40.12±9.78、(0.00±0.00)分，差异均有统计学意义(P<0.05)。单因素分析结果显示，神经功能恢复不良组和神经功能恢复良好组患者的男性、高血压史、糖尿病史、饮酒史、吸烟史占比，年龄、体质量指数(BMI)、甘油三酯(TC)、低密度脂蛋白(LDL)、血清肌酐(SCr)、同型半胱氨酸(Hcy)、白细胞计数(WBC)、中性粒细胞计数(NEU)、胱抑素C (Cys C)水平比较差异均无统计学意义(P>0.05)。神经功能恢复不良组患者溶栓前的NIHSS评分、UA水平分别为(4.81±1.33)分、(339.72±45.14) mol/L，明显低于神经功能恢复良好组的(10.19±2.23)分、(397.56±48.63) mol/L；TG、miR-34a、超敏C反应蛋白(hs-CRP)、D-二聚体(D-D)水平分别为(1.78±0.45) mmol/L、61.77±8.96、(10.45±3.06) mg/L、(0.63±0.21) mg/L，明显高于神经功能恢复良好组的(1.17±0.33) mmol/L、47.67±7.64、(7.68±2.86) mg/L、(0.51±0.18) mg/L，差异均有统计学意义(P<0.05)。经Logistic回归分析结果显示，溶栓前NIHSS评分、TG、miR-34a、UA水平均是影响脑卒中患者神经功能恢复不良的危险因素(P<0.05)。经Pearson相关性分析结果显示，血清miR-34a水平与脑卒中患者mRS评分呈正相关(r=0.581，P<0.01)。结论 rt-PA静脉溶栓治疗的脑卒中患者治疗前血清miR-34a水平与神经功能恢复情况具有一定的相关性，血清miR-34a低表达有助于患者神经功能的恢复。
      【关键词】 微小RNA-34a；脑卒中；重组组织型纤溶酶原激活剂；神经功能；相关性
      【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1003—6350（2022）12—1520—05

Correlation between serum miR-34a and neurological recovery after intravenous thrombolysis with rt-PA in strokepatients.
YANG Xiao-jing, LIU Qian. Department of Neurology, Baoji People's Hospital, Baoji 721000, Shaanxi, CHINA
【Abstract】 Objective To analyze the correlation between serum miR-34a and the recovery of neurologicalfunction after intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in stroke patients.Methods A total of 98 stroke patients treated by intravenous thrombolysis with rt-PA who were admitted to the Depart-ment of Neurology, Baoji People's Hospital from December 2019 to December 2020 were selected and included in thestudy group. At the same time, 62 healthy volunteers who visited the Health Examination Center of the hospital for physi-cal examination were selected and included in the control group. The serum miR-34a levels of the two groups were de-tected, and the modified Rankin scale (mRS) was used to evaluate the neurological function of the two groups of sub-jects. The patients in the study group were divided into a good neurological function recovery group and a poor neurolog-ical function recovery group according to the mRS score. Logistic regression analysis was used to analyze the risk fac-tors for poor neurological recovery in stroke patients. Pearson correlation analysis method was used to analyze the corre-lation between serum miR-34a level and neurological function recovery of stroke patients. Results The serummiR-34a level and mRS score of the patients in the study group were 53.57±10.69 and (2.72±0.78) points, respectively,which were significantly higher than 40.12±9.78 and (0.00±0.00) points in the control group (P<0.05). Univariate analy-sis results showed that there was no statistically significant difference between the patients with poor neurological func-tion recovery and those with good neurological function recovery in the proportion of males, history of hypertension, his-tory of diabetes, history of alcohol consumption, history of smoking, age, body mass index (BMI), triglyceride (TC), lowdensity lipoprotein (LDL), serum creatinine (SCr), homocysteine (Hcy), white blood cell count (WBC), neutrophil count(NEU), cystatin C (Cys C) levels (P>0.05). The NIHSS score and UA level before thrombolysis in the patients with poor