目的 探究微小RNA-23b(miR-23b)、微小RNA-34a(miR-34a)在急性脑梗死(ACI)患者血清的表达水平与颈总动脉内膜中层厚度(IMT)的相关性。方法 选择2016年6月至2019年1月于本院收治的168例ACI患者进行研究,称ACI组；并收取同期本院172例体检正常者进行对照研究,称对照组。比较分析两组一般资料；采用实时荧光定量PCR(qRT-PCR)法两组血清miR-23b、miR-34a、血管细胞粘附分子-1(VCAM-1)、肿瘤坏死因子-α(TNF-α)水平；使用彩色多普勒超声仪检测IMT； 分析ACI患者血清miR-23b、miR-34a、IMT水平与VCAM-1、TNF-α的关系及miR-23b、miR-34a水平与IMT水平的相关性；Logistic回归分析ACI的影响因素。结果 ACI组患者血清总胆固醇、三酰甘油、低密度脂蛋白、miR-23b、miR-34a、IMT、VCAM-1、TNF-α水平均高于对照组(P均<0.05),高密度脂蛋白低于对照组(P<0.05)； ACI患者血清miR-23b、miR-34a、IMT水平均与VCAM-1、TNF-α水平、miR-23b、miR-34a表达水平与IMT均呈正相关(P均<0.05)；低密度脂蛋白、miR-23b、miR-34a、IMT、VCAM-1、TNF-α是影响ACI发生的危险因素(P＜0.05)。结论 ACI患者血清miR-23b、miR-34a高表达,两者均与IMT呈正相关,miR-23b、miR-34a可能与IMT相互作用,共同影响ACI疾病的发展过程。

Objective To explore the correlations between the levels of serum microRNA-23b (miR-23b), microRNA-34a (miR-34a) and carotid intima-media thickness (IMT) in patients with acute cerebral infarction (ACI). Methods 168 patients with ACI admitted to our hospital from June 2016 to January 2019 were selected as the ACI group; 172 cases of normal physical examination in our hospital during the same period were collected for the comparative study, which was called the control group. The general data of the two groups were compared and analyzed; the levels of serum miR-23b, miR-34a, vascular cell adhesion molecule-1 (VCAM-1) and tumor necrosis factor-α (TNF-α) were measured by real-time fluorescence quantitative PCR (qRT-PCR); IMT was detected by color Doppler ultrasound; the relationships between levels of serum miR-23b, miR-34a, IMT and VCAM-1, TNF-α, and the correlations between levels of miR-23b, miR-34a and IMT in ACI patients were analyzed; Logistic regression was used to analyze the influencing factors of ACI. Results The levels of serum total cholesterol, triglyceride, low density lipoprotein, miR-23b, miR-34a, IMT, VCAM-1 and TNF-α in ACI group were higher than those in control group (all P < 0.05), and high density lipoprotein was lower than that in control group (P < 0.05); the levels of serum miR-23b, miR-34a and IMT were positively correlated with levels of VCAM-1, TNF-α, miR-23b and miR-34a in ACI patients (all P < 0.05); low density lipoprotein, miR-23b, miR-34a, IMT, VCAM-1 and TNF-α were risk factors for ACI (P < 0.05). Conclusions The levels of serum miR-23b and miR-34a in patients with ACI are high, both of them are positively correlated with IMT, and miR-23b and miR-34a may interact with IMT and affect the development of ACI.