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目的 探讨血清外泌体源性环状RNA Tousled样激酶1(circTLK1)与老年急性脑梗死病情严重程度及预后的关系。方法 选取2021年10月至2022年11月恩施土家族苗族自治州中心医院脑病科收治的老年急性脑梗死患者128例(急性脑梗死组),采用美国国立卫生研究院卒中量表(NIHSS)评分评估病情严重程度。急性脑梗死组90 d时又根据改良的Rankin量表(mRS)评分分为预后不良组46例和预后良好组82例。另选取健康体检者80例(对照组)。RT-PCR检测血清外泌体源性circTLK1表达。出院后对老年急性脑梗死患者进行随访，90 d时用mRS评分对预后进行评价。结果 急性脑梗死组血清外泌体源性circTLK1表达明显高于对照组(1.86±0.46 vs 0.87±0.12,P<0.05)。轻度、中度和重度急性脑梗死患者血清外泌体源性circTLK1表达逐渐升高(1.34±0.28 vs 1.78±0.19 vs 2.35±0.33,P<0.05)。预后不良组入院时NIHSS评分和circTLK1表达明显高于预后良好组[(13.21±3.24)分vs(9.55±2.16)分，P=0.001;2.15±0.77 vs 1.47±0.58,P=0.001]。多因素logistic回归分析显示，入院时NIHSS评分和circTLK1表达是老年急性脑梗死患者不良预后的独立影响因素(OR=4.123,95%CI:1.109～12.520,P=0.001;OR=2.734,95%CI:1.067～6.135,P=0.001)。ROC曲线分析显示，血清外泌体源性circTLK1表达预测急性脑梗死患者预后的曲线下面积为0.831,敏感性和特异性分别为96.19%、85.20%。结论老年急性脑梗死患者血清外泌体源性circTLK1表达升高，其表达越高，病情可能越重，且预后不良。
Abstract：Objective To investigate the relationship of serum exocrine cyclic RNA Tousled-like kinase 1(circTLK1) with the severity and prognosis of acute cerebral infarction in the elderly.Methods One hundred and twenty-eight elderly patients with acute cerebral infarction(acute cerebral infarction group) admitted to Department of Encephalopathy of Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from October 2021 to November 2022 were recruited.NIHSS was used to assess their severity.At 90 d, the patients was further divided into poor prognosis group(46 cases) and good prognosis group(82 cases) based on the modified Rankin scale(mRS) score.Another 80 healthy individuals who taking physical examination were selected as the control group.The expression of circTLK1 in serum exocrine was detected by RT-PCR.The elderly patients with acute cerebral infarction were followed up after discharge, and the prognosis was evaluated with the mRS score on the 90th day.Results The relative expression of serum exosome-derived circTLK1 was significantly higher in the acute cerebral infarction group than the control group(1.86±0.46 vs 0.87±0.12,P<0.05),and the level was gradually increased in the patients with mild, moderate, and severe acute cerebral infarction(1.34±0.28 vs 1.78±0.19 vs 2.35±0.33,P<0.05).The NIHSS score and circTLK1 level at admission were significantly higher in the poor prognosis group than in the good prognosis group(13.21±3.24 vs 9.55±2.16,P=0.001;2.15±0.77 vs 1.47±0.58,P=0.001).Multivariate logistic regression analysis showed that the two indicators were independent influencing factors for poor prognosis of elderly patients with acute cerebral infarction(OR=4.123,95%CI:1.109-12.520,P=0.001;OR=2.734,95%CI:1.067-6.135,P=0.001).The AUC of serum exocrine circTLK1 in predicting the prognosis of patients with acute cerebral infarction was 0.831,with a sensitivity and specificity of 96.19% and 85.20%,respectively.Conclusion The expression level of serum exocrine circTLK1 is increased in elderly patients with acute cerebral infarction, and the higher the expression level, the worse the condition and the prognosis.
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基本信息:
中图分类号:R743.33
引用信息:
[1]黄杰,黄年平,饶骞,等.外泌体源性环状RNA Tousled样激酶1与老年急性脑梗死病情严重程度及预后的关系[J].中华老年心脑血管病杂志,2023,25(09):962-965.
基金信息:
湖北省卫生健康委科研项目(2019CC040-09)
2023-09-11
2023-09-11