【摘要】 目的 探究急性缺血性脑卒中（acute ischemic stroke）患者长链非编码核糖核酸性别决定相关基因簇2重叠转录本（long non-coding RNA sex determination related gene cluster 2 overlapping transcript,lncRNA SOX2OT）、微小RNA(microRNA,miR)-331水平对不稳定斑块形成和重度神经功能缺损的诊断价值。方法 选取2020年3月～2021年11月张家口市第二医院神经内科收治的120例急性缺血性脑卒中患者为研究组，另选取同期该院健康体检人员120例作为对照组。根据颈动脉超声检查情况将患者分为无斑块组24例、稳定斑块组40例和不稳定斑块组56例；依据患者入院时美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）评分将患者分为轻度神经功能缺损组51例、中度神经功能缺损组47例和重度神经功能缺损组22例；实时荧光定量PCR法检测研究组和对照组血清lncRNA SOX2OT和mi R-331水平；Pearson法分析急性缺血性脑卒中患者血清lncRNA SOX2OT和mi R-331水平的相关性；受试者工作特征（receiver operating characteristic,ROC）曲线分析血清lncRNA SOX2OT,miR-331水平对急性缺血性脑卒中患者不稳定斑块形成和重度神经功能缺损的诊断价值。结果 与对照组比较，研究组血清lncRNA SOX2OT水平明显升高（1.86±0.47 vs 1.00±0.03）,miR-331水平明显降低（0.51±0.14 vs 1.02±0.04），差异有统计学意义（t=20.004,38.370，均P <0.001）；无斑块组、稳定斑块组和不稳定斑块组血清lncRNA SOX2OT水平依次升高（1.27±0.31,1.78±0.45,2.18±0.56）,miR-331水平依次降低（0.74±0.19,0.56±0.16,0.37±0.10），差异均有统计学意义（F=30.671,60.656，均P <0.001）；轻度神经功能缺损组、中度神经功能缺损组和重度神经功能缺损组血清lncRNA SOX2OT水平依次升高（1.58±0.41,1.94±0.48,2.35±0.60）,miR-331水平依次降低（0.67±0.18,0.46±0.12,0.27±0.07），差异均有统计学意义（F=21.100,65.923，均P <0.001）；急性缺血性脑卒中患者血清lncRNA SOX2OT与miR-331水平呈负相关（r=-0.467,P <0.001）；血清lncRNA SOX2OT和miR-331水平单独及二者联合诊断急性缺血性脑卒中患者不稳定斑块形成的曲线下面积（area under curve,AUC）分别为0.819,0.766和0.921，血清lncRNA SOX2OT和miR-331水平单独及二者联合诊断急性缺血性脑卒中患者重度神经功能缺损的AUC分别为0.716,0.801和0.904，二者联合优于血清lncRNA SOX2OT和miR-331单独诊断（Z=2.211,3.179,2.673,2.081，均P <0.05）。结论 急性缺血性脑卒中患者血清lncRNA SOX2OT水平呈高表达，miR-331水平呈低表达，二者可作为评估急性缺血性脑卒中患者不稳定斑块形成和重度神经功能缺损的生物学指标。更多还原

【Abstract】 Objective To explore the diagnostic value of serum long non-coding RNA sex determination related gene cluster 2overlapping transcript(lncRNA SOX2OT) and microRNA-331(miR-331) in patients with acute ischemic stroke for unstable plaque formation and severe neurological deficit. Methods A total of 120 patients with acute ischemic stroke admitted to Department of Neurology of the Zhangjiakou Second Hospital from March 2020 to November 2021 were selected as the study group, and 120 health examination personnel in the hospital at the same time were selected as the control group. According to the carotid ultrasound examination, the patients were divided into non plaque group 24 cases, stable plaque group 40 cases and unstable plaque group 56 cases and according to the National Institutes of Health Stroke Scale(NIHSS) score at admission, the patients were divided into mild neurological deficit group 51 cases, moderate neurological deficit group 47 cases and severe neurological deficit group 22 cases. The levels of serum lncRNA SOX2OT and miR-331 in study group and control group was detected by real-time fluorescent quantitative PCR. Pearson method was used to analyze the correlation between serum lncRNA SOX2OT and miR-331 levels in patients with acute ischemic stroke, and the receiver operating characteristic curve was used to analyze the diagnostic value of serum lncRNA SOX2OT and miR-331 levels in unstable plaque formation and severe neurological deficit in patients with acute ischemic stroke. Results Compared with the control group, the level of serum lncRNA SOX2OT in the study group was significantly higher(1.86±0.47 vs 1.00±0.03) and the level of miR-331 was significantly lower(0.51±0.14 vs 1.02±0.04),the differences were statistically significant(t=20.004, 38.370, all P < 0.001).The level of serum lncRNA SOX2OT increased in turn(1.27±0.31, 1.78±0.45, 2.18±0.56) in non plaque group, stable plaque group and unstable plaque group, and the level of miR-331 decreased in turn(0.74±0.19, 0.56±0.16, 0.37±0.10),the differences were statistically significant(F=30.671, 60.656, all P < 0.001). The level of serum lncRNA SOX2OT increased(1.58±0.41, 1.94±0.48, 2.35±0.60) in turn in mild neurological deficit group, moderate neurological deficit group and severe neurological deficit group, and the level of miR-331 decreased in turn(0.67±0.18, 0.46±0.12, 0.27±0.07),the differences were statistically significant(F=21.100, 65.923, all P < 0.001). There was a negative correlation between serum lncRNA SOX2OT and miR-331 level in patients with acute ischemic stroke(r=-0.467, P < 0.001).The area under curve(AUC) of serum lncRNA SOX2OT and miR-331 levels alone and in combination for the diagnosis of unstable plaque formation in patients with acute ischemic stroke were 0.819, 0.766 and 0.921, respectively. The AUC of serum lncRNA SOX2OT and miR-331 levels alone and in combination in the diagnosis of severe neurological deficit in patients with acute ischemic stroke were 0.716, 0.801 and 0.904, respectively, and the combination of the two was better than the diagnosis of serum lncRNA SOX2OT and miR-331 alone(Z=2.211, 3.179, 2.673, 2.081, all P < 0.05). Conclusion The level of serum lncRNA SOX2OT in patients with acute ischemic stroke was high and the level of miR-331 was low. They can be used as biological indicators to evaluate the formation of unstable plaque and severe neurological deficit in patients with acute ischemic stroke.更多还原