探讨血清长链非编码RNA（LncRNA）ZEB1-AS1在缺血性脑卒中双重抗血小板治疗患者中的表达水平及其对卒中复发的预测价值。

选取2023年1月至2024年12月于首都医科大学附属北京康复医院接受氯吡格雷和阿司匹林双重抗血小板治疗的280例缺血性脑卒中患者作为试验组，纳入同期进行体检的健康居民100例作为对照组，收集所有研究对象血清样本并测定LncRNA ZEB1-AS1的表达水平，评估患者的神经功能[美国国立卫生研究院卒中量表（NIHSS）评分]、意识障碍[格拉斯哥昏迷评分量表（GCS）评分]和日常生活能力[改良Rankin量表（mRS）评分]。通过6个月随访记录患者的卒中复发情况，根据随访结果将患者分为复发组和未复发组。分析LncRNA ZEB1-AS1表达水平与卒中复发及预后之间的关系。采用t检验比较组间LncRNA ZEB1-AS1表达水平的差异，应用Pearson相关分析血清ZEB1-AS1水平与各量表评分的相关性，采用Logistic回归分析影响缺血性脑卒中复发的危险因素，同时构建受试者操作特征（ROC）曲线分析血清ZEB1-AS1表达水平对缺血性脑卒中患者双重抗血小板治疗后卒中复发的预测效能。

随访6个月后，78例患者出现复发（复发组），202例未出现复发（未复发组）。复发组患者血清ZEB1-AS1相对表达量显著高于未复发组（0.96±0.18 vs 0.82±0.14），差异有统计学意义（t=7.168，P<0.001）；对照组血清ZEB1-AS1相对表达量为0.52±0.10，均显著低于复发组和未复发组，差异均有统计学意义（t=20.535、18.419，P均<0.001）。Pearson相关分析结果显示：血清ZEB1-AS1水平与NIHSS评分和mRS评分之间均呈正相关（r=0.55、0.57，P均<0.001），与GCS评分之间呈负相关（r=-0.52，P<0.001）。Logistic回归分析结果显示，血清ZEB1-AS1（OR =20.311，95%CI：1.309~315.057）是影响缺血性脑卒中复发的独立危险因素（P<0.05）。ROC曲线分析结果显示，血清ZEB1-AS1表达预测接受双重抗血小板治疗缺血性脑卒中复发的曲线下面积为0.77。

血清LncRNA ZEB1-AS1在缺血性脑卒中双重抗血小板治疗患者中具有较高的表达水平，其高表达与卒中复发密切相关，有望作为预测缺血性脑卒中患者卒中复发的潜在生物标志物。

To investigate the serum expression levels of long non-coding RNA (LncRNA) ZEB1-AS1 in patients with ischemic stroke undergoing dual antiplatelet therapy, and to evaluate its predictive value for stroke recurrence.

The study included 280 ischemic stroke patients treated with clopidogrel and aspirin (the treatment group) and 100 healthy physical examination participants (the control group) between January 2023 and December 2024 at Beijing rehabilitation hospital affiliated to capital medical university. Serum samples were collected and the expression levels of LncRNA ZEB1-AS1 were determined. Neurological function was assessed using the National Institutes of Health stroke scale (NIHSS), consciousness impairment with the Glasgow Coma scale (GCS), and daily living ability with the modified Rankin scale (mRS). Patients were followed for 6 months to record stroke recurrence and were subsequently categorized into recurrence and non-recurrence groups based on follow-up outcomes. The correlation between LncRNA ZEB1-AS1 expression levels and stroke recurrence and prognosis was thoroughly examined. The t-test was used to compare the differences in the expression levels of LncRNA ZEB1-AS1 between different groups. Pearson correlation analysis was used to assess the relationship between serum ZEB1-AS1 levels and clinical scale scores. Logistic regression was used to identify the risk factors for ischemic stroke recurrence, while ROC curve analysis was used to analyze the predictive efficacy of serum ZEB1-AS1 expression levels for stroke recurrence after dual antiplatelet therapy in patients with ischemic stroke.

During the 6-month follow-up, 78 of 280 ischemic stroke patients experienced recurrence (recurrence group), while 202 did not (non-recurrence group). Serum ZEB1-AS1 expression was significantly higher in the recurrence group (0.96±0.18) than in the non-recurrence group (0.82±0.14; t=7.168, P<0.001). The control group showed significantly lower expression (0.52±0.10) than both the recurrence and non-recurrence groups (t=20.535 and 18.419, respectively; both P<0.001). Pearson correlation analysis showed that positive correlations between serum ZEB1-AS1 levels and NIHSS (r=0.55) and mRS scores (r=0.57), and a negative correlation with GCS scores (r=-0.52; all P<0.001). Logistic regression identified serum ZEB1-AS1 as an independent risk factor for stroke recurrence (OR=20.311, 95%CI: 1.309-315.057; P<0.05). ROC curve analysis showed that serum ZEB1-AS1 expression predicted the AUC of stroke recurrence after double-antibody therapy was 0.77.

In patients with ischemic stroke undergoing dual antiplatelet therapy, serum lncRNA ZEB1-AS1 levels are significantly associated with stroke recurrence, suggesting its potential value as a prognostic biomarker for predicting recurrence.