2025 年第 7 期 第 20 卷

急性脑梗死患者外周血环状RNA TTC3和微小RNA-135b-5p表达与神经功能缺损及预后的相关性

Correlation between the expression of circular RNA TTC3 and microRNA-135b-5p in peripheral blood and neurological deficits and prognosis in patients with acute cerebral infarction

作者：孙健孙炎张帆程怡宋爱霞

英文作者：Sun Jian Sun Yan Zhang Fan Cheng Yi Song Aixia

单位：河北北方学院附属第一医院神经内科，张家口075000

英文单位：Department of Neurology the First Affiliated Hospital of Hebei North University Zhangjiakou 075000 China

关键词：急性脑梗死；神经功能缺损；预后；环状RNATTC3；微小RNA-135b-5p

英文关键词：Acutecerebralinfarction;Neurologicaldeficits;Prognosis;CircularRNATTC3；MicroRNA-135b-5p

• 摘要：

• 目的 探讨急性脑梗死（ACI）患者外周血环状RNA TTC3(circTTC3)、微小RNA-135b-5p（miR-135b-5p）表达情况，分析其与患者神经功能缺损和预后的关系。方法 选择2022年1月至2024年6月河北北方学院附属第一医院收治的ACI患者149例（观察组），另选取健康体检人员120例为对照组，比较2组外周血circTTC3、miR-135b-5p表达情况，分析circTTC3、miR-135b-5p与美国国立卫生研究院卒中量表（NIHSS）评分的相关性。分析影响患者预后的相关因素，绘制受试者工作特征曲线分析circTTC3、miR-135b-5p对ACI患者预后不良的预测价值。结果 观察组外周血circTTC3表达量高于对照组［（1.7±0.4）比（1.1±0.3）］，miR-135b-5p表达量低于对照组［（0.76±0.24）比（1.09±0.36）］（均P＜0.001）。轻度组、中度组、重度组ACI患者外周血circTTC3表达量逐渐升高，miR-135b-5p表达量逐渐降低，组间两两比较差异均有统计学意义（均P＜0.01）。观察组外周血circTTC3表达量与NIHSS评分呈正相关（r=0.318，P=0.006），miR-135b-5p表达量与NIHSS评分呈负相关（r=-0.295，P=0.009），外周血circTTC3表达量与miR-135b-5p表达量呈负相关（r=-0.272，P=0.011）。多因素Logistic回归分析结果显示，NIHSS评分、低密度脂蛋白胆固醇、circTTC3、miR-135b-5p是ACI患者预后不良的独立影响因素（均P＜0.05）。circTTC3、miR-135b-5p联合预测ACI患者预后不良的曲线下面积为0.902，95%置信区间为0.829～0.953，敏感度和特异度分别为93.42%、71.51%。结论 ACI患者外周血circTTC3表达增加，miR-135b-5p表达降低，二者均为患者预后的独立影响因素，联合应用在ACI患者预后预测中具有较高的临床价值。

• Objective  To investigate the expression of circular RNA TTC3 (circTTC3) and microRNA-135b-5p (miR-135b-5p) in peripheral blood of patients with acute cerebral infarction (ACI), and to analyze their relationship with neurological deficits and prognosis. Methods A total of 149 ACI patients admitted to the First Affiliated Hospital of Hebei North University from January 2022 to June 2024 were selected as the observation group, and 120 healthy physical examination persons were selected as the control group. The expression of circTTC3 and miR-135b-5p in peripheral blood of the two groups was compared, and the correlation between circTTC3, miR-135b-5p and the National Institutes of Health Stroke Scale (NIHSS) score was analyzed.The related factors affecting the prognosis of ACI patients were analyzed, and the receiver operating characteristic curve was drawn to analyze the predictive value of circTTC3 and miR-135b-5p in the poor prognosis of ACI patients. Results The expression of circTTC3 in peripheral blood of the observation group was higher than that of the control group ［（1.7±0.4） vs （1.1±0.3）］, and the expression of miR-135b-5p was lower than that of the control group ［（0.76±0.24） vs （1.09±0.36）］(both P＜0.01). The expression of circTTC3 in peripheral blood of ACI patients in the mild group, moderate group and severe group gradually increased, and the expression of miR-135b-5p gradually decreased, and the differences between any two groups were statistically significant (all P＜0.01). In the observation group, the expression of circTTC3 in peripheral blood was positively correlated with the NIHSS score(r=0.318, P=0.006), and the expression of miR-135b-5p was negatively correlated with the NIHSS score(r=-0.295, P=0.009), and the expression of circTTC3 in peripheral blood was negatively correlated with the expression of miR-135b-5p (r=-0.272, P=0.011). Multivariate Logistic regression analysis showed that NIHSS score, low-density lipoprotein cholesterol, circTTC3 and miR-135b-5p were the independent risk factors for poor prognosis of ACI patients (all P＜0.05). The area under the curve of circTTC3 and miR-135b-5p in predicting the poor prognosis of ACI patients was 0.902, the 95% confidence interval was 0.829-0.953, the sensitivity and specificity were 93.42% and 71.51%, respectively. Conclusion The expression of circTTC3 is increased and the expression of miR-135b-5p is decreased in the peripheral blood of patients with acute cerebral infarction. Both of them are independent factors affecting the prognosis of patients with acute cerebral infarction, and their combined use has high clinical value in predicting the prognosis of patients with acute cerebral infarction.