血清miR-122 HSP70 TNF-α与NIHSS评分相关性及对急性缺血性脑卒中患者预后的影响OA

Objective To investigate the correlation between microRNA-122(miR-122),heat shock protein 70(HSP70),tumor necrosis factor-α(TNF-α)and National Institutes of Health Stroke Scale(NIHSS)score and its impact on the prognosis of patients with acute ischemic stroke(AIS).Methods A total of 120 AIS patients admitted to our Hospital from January 2023 to February 2025 were selected.According to the modified Rankin scale(mRS)score after 3 months of follow-up,they were divided into poor prognosis group(3-5 scores,41 cases)and good prognosis group(0-2 scores,79 cases).The baseline data and levels of miR-122,HSP70 and TNF-α before treatment were compared between the two groups.Pearson correlation analysis was used to analyze the relationship between each index and baseline NIHSS score.Multivariate Logistic regression analysis was used to analyze the prognostic factors.The receiver operating characteristic curve(ROC)was used to evaluate the predictive value of miR-122,HSP70,TNF-α and their combination before treatment.Results The baseline NIHSS score,miR-122 and TNF-α levels in the poor prognosis group were higher than those in the good prognosis group,and the HSP70 level was lower than that in the good prognosis group(all P<0.05).Pearson correlation analysis showed that the levels of miR-122 and TNF-α before treatment were positively correlated with baseline NIHSS score(r=0.514,0.530,both P<0.001),and the level of HSP70 was negatively correlated with baseline NIHSS score(r=-0.565,P<0.001).Multivariate Logistic regression analysis showed that the levels of miR-122,HSP70 and TNF-α before treatment were related factors affecting the prognosis of AIS patients(P<0.05),and after adjusting the baseline NIHSS score,the three were still independent factors affecting the prognosis of AIS patients(P<0.05).ROC analysis showed that the AUC of miR-122,HSP70,TNF-α levels before treatment and combined prediction of prognosis were 0.749(95%CI:0.662-0.824),0.734(95%CI:0.645-0.810),0.766(95%CI:0.680-0.838),0.889(95%CI:0.818-0.939),respectively.The DeLong test showed that the combined AUC was significantly higher than the AUC values of the three alone(Z=2.340,2.663,2.141,P=0.019,0.008,0.032).Conclusion miR-122,HSP70 and TNF-α are related to NIHSS score and prognosis of AIS patients.The combined detection of the three can improve the accuracy of prognosis prediction and provide reference for early risk stratification and prognosis evaluation of AIS.