关键词: 肿瘤坏死因子受体相关因子4, 微小RNA-4443, 出血性脑卒中, 预后, 神经功能, 相关性

Abstract:

Objective To investigate the changes of serum miR-4443 and tumor necrosis factor receptor-associated factor（TRAF） 4 expression levels in patients with hemorrhagic stroke，and to analyze the clinical value. Methods Totally，77 patients admitted to Baoding First Central Hospital from June to December 2020 who were diagnosed as hemorrhagic stroke were enrolled as stroke group. The National Institute of Health Stroke Scale（NIHSS） score was used to evaluate the degree of neurological impairment，the 77 patients were classified into mild group（<6，29 cases），moderate group（6-13，27 cases） and severe group（>13，21 cases）. The stroke group was followed up for 6 months，and the good prognosis group（32 cases） and poor prognosis group（45 cases） were established according to the prognosis of patients. Another 48 healthy subjects were enrolled as healthy control group. Pearson correlation coefficient was used to analyze the correlation between miR-4443，TRAF4 levels and the NIHSS score of patients with hemorrhagic stroke. Receiver operating characteristic（ROC） curve was used to analyze the predictive values of miR-4443，TRAF4 and the combined determination for the prognosis of patients with hemorrhagic stroke. Results Compared with healthy control group，the expression level of miR-4443 in stroke group was decreased（P<0.01），and the expression level of TRAF4 was increased（P<0.01）. The expression level of miR-4443 in stroke group was decreased with the severity of disease（P<0.001），while the expression level of TRAF4 was increased with the severity of disease（P<0.001）. Pearson correlation coefficient analysis showed that NIHSS score was negatively correlated with miR-4443 expression level（r=-0.857，P<0.001），and it was positively correlated with TRAF4 expression level（r=0.805，P<0.001）. The expression level of miR-4443 in poor prognosis group was decreased compared with that in good prognosis group（P<0.05），and the expression level of TRAF4 was increased compared with that in good prognosis group（P<0.05）. ROC curve analysis showed that the area under curve（AUC） of combined determination（0.964） was increased than those of single determinations （0.686 and 0.790）（P<0.05）. Conclusions The development degree of hemorrhagic stroke is related with the expression levels of miR-4443 and TRAF4，which have a value for the prognosis of patients.

Key words: Tumor necrosis factor receptor-associated factor 4, MicroRNA-4443, Hemorrhagic stroke, Prognosis, Neurological function, Correlation