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目的探讨外周血let-7e-5 p的表达水平与缺血性脑卒中发病风险之间的关联,以及其作为缺血性脑卒中生物标记物的可行性。方法选择302例2013年在深圳市人民医院确诊的缺血性脑卒中初发病例,以及302例与之年龄性别相匹配的在医院做常规健康检查的对照,采用实时定量PCR检测外周全血let-7e-5 p的表达水平,多元logistic回归分析miRNA表达水平与缺血性脑卒中发生的关联,应用受试者工作特征曲线(ROC)和重新分类方法分析miRNA是否可作为判断缺血性脑卒中的依据。结果缺血性脑卒中病例外周血中let-7e-5 p的表达水平高于对照,差异有统计学意义(P<0.05)。let-7e-5 p表达水平升高与缺血性脑卒中发病风险的增加存在显著关联性[OR=2.13,95%CI,1.75~2.59]。与传统危险因素模型相比,加入let-7e-5 p可以显著增加曲线下面积且差异有统计学意义(P<0.05),重分类改善幅度为16.76%(95%CI:11.16%~22.37%),综合判别指数为0.10(95%CI:0.08~0.13)。另外,病例组中let-7e-5 p表达水平与血小板数量和血小板压积呈显著负相关关系(P<0.05)。结论外周血let-7e-5 p的表达水平与缺血性脑卒中发生之间存在显著关联性,let-7e-5 p有望作为缺血性脑卒中的生物标记物。
Objective To investigate the correlation between the expression of let-7e-5 p in peripheral blood and the risk of ischemic stroke and its feasibility as biomarker of ischemic stroke. Methods A total of 302 primary ischemic stroke patients diagnosed in Shenzhen People’s Hospital in 2013 and 302 normal controls were selected for routine health checkup in the hospital of Shenzhen People’s Hospital. Real-time quantitative PCR was used to detect peripheral whole blood let -7e-5p expression levels, multivariate logistic regression analysis of miRNA expression levels associated with ischemic stroke, the application of receiver operating characteristic curve (ROC) and reclassification method to analyze whether miRNA can be used as a judge of ischemic brain Basis of stroke. Results The expression of let-7e-5 p in peripheral blood of patients with ischemic stroke was significantly higher than that of the control (P <0.05). There was a significant correlation between the increased expression of let-7e-5p and the increased risk of ischemic stroke [OR = 2.13, 95% CI, 1.75-2.59]. Compared with the traditional risk factor model, let-7e-5 p significantly increased the area under the curve with a statistically significant difference (P <0.05), with a margin of improvement of 16.76% (95% CI: 11.16% -22.37% ), The comprehensive discriminant index was 0.10 (95% CI: 0.08 ~ 0.13). In addition, the expression of let-7e-5p in the case group was negatively correlated with platelet count and platelet pressure (P <0.05). Conclusion The expression of let-7e-5 p in peripheral blood is significantly correlated with the occurrence of ischemic stroke. Let-7e-5 p is expected to be a biomarker of ischemic stroke.