ABSTRACT
Objective:To investigate the correlation and predictive value of serum miR-149-5p and matrix metalloproteinase-9 (MMP-9) and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received intravenous thrombolytic therapy in Shangqiu First People's Hospital from September 2019 to February 2022 were enrolled prospectively. They were divided into HT group and non-HT group according to whether HT occurred after intravenous thrombolysis. Serum miR-149-5p and MMP-9 were measured by real-time fluorescence quantitative polymerase chain reaction and enzyme-linked immunosorbent assay respectively. Multivariate logistic regression analysis was used to determine the independent risk factors for HT after thrombolysis. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum miR-149-5p, MMP-9 and their combination for HT after intravenous thrombolysis. Results:A total of 358 patients with AIS received intravenous thrombolytic therapy were enrolled, 71 of them (19.83%) developed HT. The serum MMP-9 in the HT group was significantly higher than that in the non-HT group (273.95±35.23 μg/L vs. 202.71±30.52 μg/L; t=17.062, P<0.001), while the serum miR-149-5p was significantly lower than that in the non-HT group (0.26±0.06 vs. 1.03±0.15; t=42.387, P<0.001). Multivariate logistic regression analysis showed that atrial fibrillation (odds ratio [ OR] 2.282, 95% confidence interval [ CI] 1.731-3.008; P<0.001), time from onset to intravenous thrombolysis ( OR 2.334, 95% CI 1.458-3.735; P<0.001), miR-149-5p ( OR 1.758, 95% CI 1.142-2.705; P=0.010) and MMP-9 ( OR 1.535, 95% CI 1.106-2.129; P=0.010) were the independent risk factors for HT after intravenous thrombolysis. Serum miR-149-5p (area under the curve 0.856, 95% CI 0.803-0.909; when the optimal cut-off value was 0.741, the sensitivity was 80.3% and the specificity was 89.9%), MMP-9 (area under the curve 0.875, 95% CI 0.821-0.929; when the optimal cut-off value was 240.051 μg/L, the sensitivity was 83.1% and the specificity was 90.2%) and their combination (area under the curve 0.897, 95% CI 0.854-0.941; sensitivity 84.5% and specificity 90.6%) had better predictive value for HT after thrombolysis, and there were no significant differences in the predictive value among the three. Conclusions:After intravenous thrombolysis, the serum miR-149-5p is lower and MMP-9 is higher at admission in patients with HT in patients with AIS. Both of them and their combination have better predictive value for HT after intravenous thrombolysis.