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目的 :探讨急性缺血性卒中早期患者外周血浆中的一组miRNAs水平与心房颤动(房颤)发生间的关系及临床意义。方法:选择2014年1月至2016年12月在我院住院的急性缺血性卒中患者,根据其是否伴发房颤分为房颤组(70例)与非房颤组(631例),另选择65名健康体检者作为对照组。比较各组间的一般临床资料及缺血性卒中患者早期血浆中一组miRNAs分子的变化;观察伴不同类型房颤与非房颤缺血性卒中患者血浆中的miRNAs差异表达;并进一步用Logistic回归分析miRNAs水平与缺血性卒中患者伴房颤发生间的关系。结果:血浆中miR-328、miR-29b和miR-150水平在房颤组、非房颤组与对照组间存在差异表达(P<0.05;P<0.01);不同于miR-328和miR-150,miR-29b在伴阵发性房颤的缺血性卒中患者血浆中的水平显著低于非房颤组缺血性卒中患者及对照组(P<0.01)。Logistic回归分析结果显示,血浆中的miR-328、miR-29b及miR-150水平与急性缺血性卒中患者伴发房颤密切相关;miR-29b水平与急性缺血性卒中患者伴发阵发性房颤密切相关。结论:急性缺血性卒中早期血浆中一组特异性miRNAs分子,特别是miR-29b有望作为急性缺血性卒中患者是否合并房颤的生物学预警指标。
Objective: To investigate the relationship between the level of miRNAs in peripheral plasma and the occurrence of atrial fibrillation (AF) in patients with acute ischemic stroke and its clinical significance. Methods: Acute ischemic stroke patients hospitalized in our hospital from January 2014 to December 2016 were divided into atrial fibrillation group (70 cases) and non-atrial fibrillation group (631 cases) according to whether they were accompanied by atrial fibrillation or not, Another 65 healthy subjects were selected as the control group. The clinical data of different groups were compared with those of a group of miRNAs in early plasma of patients with ischemic stroke. The differential expression of miRNAs in plasma of patients with different types of atrial fibrillation and non-atrial fibrillation were observed. Logistic Regression analysis of the relationship between miRNAs levels and occurrence of atrial fibrillation in ischemic stroke patients. Results: The levels of miR-328, miR-29b and miR-150 in plasma were significantly different between the AF group and the non-AF group and the control group (P <0.05; P <0.01) 150, miR-29b levels in patients with ischemic stroke with paroxysmal atrial fibrillation were significantly lower than those in non-atrial fibrillation ischemic stroke patients and controls (P <0.01). Logistic regression analysis showed that plasma levels of miR-328, miR-29b and miR-150 were closely related to acute ischemic stroke patients with atrial fibrillation; miR-29b levels were associated with acute ischemic stroke Atrial fibrillation is closely related. Conclusion: A set of specific miRNAs in plasma, especially miR-29b, in the early stage of acute ischemic stroke is expected as a biological predictor of AF in acute ischemic stroke patients.