Study On The Relationship Between Collateral Circulation And The Expression Of Serum Long Non-coding RNA MALAT1 In Cerebral Infarction Patients

Objective: Ischemic stroke is one of the common causes of death and disability.Collateral circulation plays a key role in maintaining the blood flow of ischemic brain tissue.Good collateral circulation is of great significance in saving ischemic penumbra,often indicating smaller infarct volume and better clinical prognosis.The long noncoding RNA MALAT1(LncRNA MALAT1)has been proved to be related to the proliferation,migration and angiogenesis of vascular endothelial cells.The purpose of this study was to explore the relationship between the expression level of serum LncRNA malat1 and collateral circulation in patients with cerebral infarction as well as and related influencing factors.Methods: One hundred and twenty-three patients hospitalized from April 2017 to April 2019 with cerebral infarction caused by occlusion of unilateral middle cerebral artery were enrolled.The collateral circulation was examined by digital subtraction angiography(DSA).After centrifugation of venous blood,serum was collected and measured by real-time Quantitative PCR to examine the expression level of LncRNA MALAT1.According to the results of The American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology collateral circulation evaluation system,the patients were classified as non-collateral group(62 cases)from grade 0 to grade 1 and collateral group(61 cases)from grade 2 to grade 4.The clinical baseline data of the two groups were analyzed and compared by Mann-Whitney U test and chi square test.The expression level of serum LncRNA MALAT1 in the two groups was compared by independent sample student-T test.The influencing factors of collateral circulation were analyzed by logistic univariate and multivariate regression model,and the relationship between serum LncRNA MALAT1 and collateral circulation was further analyzed by Spearman’s correlation.The predictive value of expression level of LncRNA MALAT1 on collateral circulation was evaluated by receive operating characteristic curve(ROC).Univariate and multivariate linear regression were used to further evaluate the possible influencing factors of the expression level of LncRNA MALAT1.Results: Among the 123 patients,the median age of the collateral group was 61 years old(Interquartile Range,IQR: 55-70 years old),males accounting for 54.1%;the median age of the non-collateral group was 60 years(IQR: 55.75-68.25 years old),males accounting for 75.8%.There were significant differences in NIHSS score of discharge,infarct area,uric acid level and cerebral blood flow(CBF)perfusion measured by arterial spin labeling between the two groups(P < 0.05).There was significant difference in the expression of serum LncRNA MALAT1 between the two groups(P < 0.05).Logistic univariate analysis showed that age,history of coronary heart disease,uric acid level,expression of Lnc RNA MALAT1,CBF difference in infarct region(Δ CBF ROI)and infarct area were all related factors of collateral circulation in patients with cerebral infarction.Multivariate regression analysis showed history of coronary heart disease,NIHSS score of discharge,expression of LncRNA MALAT1 and Δ CBF ROI were independent factors related to collateral circulation(P < 0.05).Spearman correlation analysis further demonstrated that there was a significant correlation between the relative expression of LncRNA MALAT1 and collateral circulation in patients with cerebral infarction,with a correlation coefficient of 0.668(P = 0.001).The area under ROC curve revealed the predictive value of expression of LncRNA MALAT1 was 0.572(95% CI:0.510-0.674;P = 0.046 < 0.05).In univariate linear regression analysis,collateral circulation,history of hypertension,uric acid level,Prothrombin Time(PT)and infarct area were all related factors(P < 0.05),while in multivariate analysis,only history of hypertension,collateral circulation and PT were independent factors(P < 0.05).Conclusions: Cerebral infarction patients with good collateral circulation tend to have lower NIHSS score of discharge,greater cerebral blood flow perfusion variation and greater serum LncRNA MALAT1 expression level.The serum LncRNA MALAT1 expression level was related to the past history of hypertension,collateral circulation and PT.The treatment and prediction value of serum LncRNA MALAT1 expression on collateral circulation in patients with cerebral infarction still needs further explore.