标题：微小RNA-221和巨噬细胞迁移抑制因子及血栓调节蛋白与心房颤动合并缺血性脑卒中的相关性

      作者：郭泉 1，张怡 2，李海军 2，高珊 3    咸阳市中心医院干部保健科 1、老年病科 2、临床营养科 3，陕西 咸阳 712000

      卷次： 2022年33卷18期

      【摘要】 目的 研究微小RNA-221 (miR-221)、巨噬细胞迁移抑制因子(MIF)、血栓调节蛋白(TM)与心房颤动(房颤)合并缺血性脑卒中的相关性，并探讨影响患者预后的危险因素。方法 选择2020年1月至2021年5月于咸阳市中心医院住院治疗的83例房颤合并缺血性脑卒中患者纳入研究组，根据房颤性质分为阵发性房颤组45例和持续性房颤组 38例，同时根据入院时改良的Rankin量表(mRS)评分分组，其中 22例>3分者纳入预后不良组，余61例≤3分者纳入预后良好组；另选择同期收治的60例缺血性脑卒中患者作为对照组，50例健康体检者作为健康组，比较研究组、对照组和健康组受检者的miR-221、MIF、TM水平，同时对比阵发性房颤组与持续性房颤组患者的miR-221、MIF、TM水平；比较预后良好组与预后不良组患者的一般临床资料，通过多因素Logistic回归方程分析影响房颤合并缺血性脑卒中患者预后的危险因素；采用 Pearson相关性分析评价心房增大、左房直径、射血分数、miR-221、MIF、TM与房颤合并缺血性脑卒的相关性。结果 研究组患者的miR-221、MIF、TM水平明显高于对照组和健康组，而健康组体检者的miR-221、MIF、TM水平明显低于研究组和对照组，差异均有显著统计学意义(P<0.01)；阵发性房颤组患者的miR-221、MIF、TM水平明显低于持续性房颤组，差异均有显著统计学意义(P<0.01)；预后良好组患者的年龄、女性、心房增大、左房直径、射血分数、miR-221、MIF、TM水平明显低于预后不良组，差异均有统计学意义(P<0.05或<0.01)；经Pearson相关性分析结果显示，心房增大、左房直径、射血分数、miR-221、MIF、TM与房颤合并缺血性脑卒中呈正相关(r=0.244、0.178、0.365、0.135、0.224、0.319、0.268，P<0.05)；多因素Logistic回归方程分析结果显示，miR-221、MIF、TM是房颤合并缺血性脑卒中的危险因素(P<0.05)。结论 miR-221、MIF、TM与房颤合并缺血性脑卒中存在密切相关性，且对患者预后的影响较大，临床上应给予重点关注。
      【关键词】 房颤；缺血性脑卒中；血栓调节蛋白；miR-221；巨噬细胞迁移抑制因子；相关性
      【中图分类号】 R541.7+5 【文献标识码】 A 【文章编号】 1003—6350（2022）18—2321—05

Correlation analysis of microRNA-221, macrophage migration inhibitory factor, thrombomodulin and atrialfibrillation complicated with ischemic stroke.
GUO Quan 1, ZHANG Yi 2, LI Hai-jun 2, GAO Shan 3. Officer Health Section 1,Department of Geriatrics 2, Department of Clinical Nutrition 3, Xianyang Central Hospital, Xianyang 712000, Shaanxi,CHINA
【Abstract】 Objective To study the correlation between microRNA-221 (miR-221), macrophage migration in-hibitory factor (MIF), thrombomodulin (TM) and atrial fibrillation (AF) complicated with ischemic stroke, and to ex-plore the risk factors influencing the prognosis of patients. Methods A total of 83 patients with atrial fibrillation com-plicated with ischemic stroke who were hospitalized in Xianyang Central Hospital from January 2020 to May 2021 wereselected and included in the study group. According to the nature of atrial fibrillation, 45 patients were divided into par-oxysmal atrial fibrillation group and 38 patients were divided into persistent atrial fibrillation group. According to themodified Rankin Scale (mRS) score at admission, 22 patients with mRS score>3 points were included in the poor prog-nosis group, and the remaining 61 patients with mRS score≤3 points were included in good prognosis group. Sixty pa-tients with ischemic stroke were selected as the control group, and 50 healthy subjects were selected as the healthygroup. The levels of miR-221, MIF, and TM in the study group, the control group, and the healthy group were com-pared. The levels of miR-221, MIF, and TM in paroxysmal atrial fibrillation group and persistent atrial fibrillation groupwere compared. The general clinical data of patients in the good prognosis group and the poor prognosis group werecompared, and risk factors influencing the prognosis of patients with atrial fibrillation complicated with ischemic strokewere analyzed by multivariate logistic regression equation. Pearson correlation analysis was used to evaluate the correla-tion of atrial enlargement, left atrial diameter, ejection fraction, miR-221, MIF, TM with atrial fibrillation complicatedwith ischemic stroke. Results The levels of miR-221, MIF, and TM in the study group were significantly higher thanthose in the control group and the healthy group, while the levels of miR-221, MIF, and TM in the healthy group weresignificantly lower than those in the study group and the control group, with statistically significant differences (P<0.01).The levels of miR-221, MIF, and TM in the paroxysmal atrial fibrillation group were significantly lower than those in