Expression And Clinical Significance Of MiR-124 In Serum And Thrombus Of Patients With Acute Ischemic Stroke

Objective:The relative expression levels of miR-124 in serum and thrombus of patients undergoing mechanical thrombectomy for acute ischemic stroke were analyzed,and the clinical significance of miR-124 in ischemic stroke was discussed.Methods:Collected acute brains with large blood vessels(carotid artery?middle cerebral artery or vertebral artery)occlusion and mechanical thrombus removal within 24 hours of onset from December 1,2018 to December31,2019,Hunan Provincial People's Hospital.Stroke patients,according to the TOAST classification criteria,patients were divided into 25 cases of cardiogenic embolism subgroup and 22 cases of atherosclerotic embolism subgroup,a total of 47 cases were included in the case group;during the same period,no physical examination was performed in our hospital Forty-three healthy people with a history of stroke and over 18 years of age were included in the control group.The thrombus extracted during mechanical thrombectomy was divided into two parts.Part of the thrombus use blind method interpretation to observe the main tissue components after specimens fixed ? paraffinsection preparation and HE staining.The other part was frozen in the-80? refrigerator to detect the relative expression of miR-124.The 4ml peripheral blood of the patients before intervention?three days after and seven days after intervention was collected,and the serum was collected after centrifugation,and stored in-80? refrigerator for testing.The general baseline characteristics of the patients' serum glucose homocysteine(HCY)triglyceride(TG)total cholesterol(TC)high-density lipoprotein cholesterol(HDL-C)low-density lipoprotein cholesterol(LDL-C),National Institute of Health Stroke Scale(NIHSS)at admission,Modified thrombolysis in cerebral ischemia(mTICI)blood flow grading,and postoperative modified Rankin Scale(mRS)were collected.NIHSS score was used to evaluate neurological functional defects,mTICI grade was used to evaluate the effect of surgical reperfusion,and mRS was used to evaluate the prognosis.The expression of mi R-124 in thrombus and serum was detected by real-time fluorescence quantitative polynucleotide chain reaction(real-time fluorescence quantitative PCR).Results:1.Serum levels of miR-124 in the cardiogenic embolization subgroup and atherosclerotic embolization subgroup at different time points(T1,T3,T7)were significantly higher than those in the control group(P<0.05),but there was no significant difference between the two subgroups.Moreover,the serum miR-124 level in the two subtypes of patients showed a decreasing trend with the change of T1,T3 and T7 at different time points.In the case group of cardiogenic embolization,T3 and T7 significantly decreased compared with T1(P<0.05),while in the atherosclerotic embolization group,T7 significantly decreased compared with T1 and T7 significantly decreased compared with T3(P<0.05).2.After controlling for such factors as age,history of hypertension,arrhythmia,and triglyceride,the expression level of miR-124 in serum was correlated with the occurrence of ischemic stroke(OR=4.078,95%ci:1.848~9.002,P=0.01).3.The analysis of thrombus components revealed that the thrombus in the cardiogenic embolization group was rich in fibrin,while the atherosclerotic thrombus was dominated by red blood cells.4.There was no significant difference in the expression level of miR-124 in the thrombus between the two subtypes of patients in the cardiogenic embolization group and the atherosclerotic embolization group(P>0.05).5.At different time(T1,T3,T7),the level of miR-124 in serum and thrombus was negatively correlated with NIHSS score(T1: r=-0.884,P=0.015).T3: r=-0.699,P=0.037;T7: r=-0.588,P=0.028;Thrombus: r=-0.612,P=0.009);Moreover,at different times(T1,T3,T7),the level of miR-124 in serum and thrombus also showed a significant negative correlation with mRS score(T1: r=-0.930,P=0.023).T3: r=-0.807,P=0.033;T7: r=-0.592,P=0.031;Thrombus: r=-0.556,P=0.016).Conclusion:After the onset of acute ischemic stroke,the serum level of miR-124 in patients increased significantly,and it showed a downward trend with time.The expression of mi R-124 in serum and thrombus was significantly negatively correlated with NIHSS score and mRS score,which may be related to miR-124 is associatied with neuroprotective effects in ischemic stroke.