目的：探讨急性脑梗死患者早期外周血清中长链非编码 RNAX 染色体失活特异转录物（lncRNA XIST）和微小核糖核酸（miRNAs）-92a水平与神经功能缺损程度的关系及意义。方法：急性脑梗死患者70 例纳入梗死组，健康体检者48例纳入对照组。根据美国国立卫生研究院卒中量表（NIHSS）对患者进行神经 功能缺损程度评分，NIHSS＜7分者纳入轻型梗死组，NIHSS≥7分者纳入重型梗死组。于脑梗死后48 h和 （或）14 d，检测脑梗死患者血清lncRNA XIST和miR-92a水平，并进行不同组别间的比较。Pearson相关及 Logistic回归分析lncRNA XIST和miR-92a水平与梗死患者NIHSS评分间的关系。结果：脑梗死后48 h时， 梗死组患者血清中lncRNA XIST相对表达量低于对照组，miR-92a的水平高于对照组（均P＜0.05）。脑梗死 后48 h时，重型梗死组患者血清中lncRNA XIST相对表达量低于轻型梗死组，miR-92a的水平为高于轻型梗 死组（均P＜0.01）。发病后14 d患者血清中lncRNA XIST相对表达量高于发病后48 h，miR-92a的水平低于 发病后48 h（均P＜0.01）。急性脑梗死患者血清中lncRNA XIST水平与NIHSS评分负相关，miR-92a水平与 NIHSS评分正相关（均P＜0.01）。lncRNA XIST和miR-92a都是急性脑梗死早期神经功能缺损程度的影响 因素（均P＜0.01）。结论：脑梗死早期血清lncRNA XIST和miR-92a与急性脑梗死早期神经功能缺损程度密 切相关，可望作为脑梗死后潜在的新分子干预靶点。

To investigate the correlation and the clinical significance between the peripheral serum long non-coding RNA (lncRNA) X-inactive specific transcript (XIST) and microRNA (miR)-92a levels and neurological impairment severity in patients with first-onset acute cerebral infraction (ACI). Methods: Seventy patients with ACI were enrolled in the study as the infarction group, and 48 healthy cases were chose as the control group. The National Institutes of Health Stroke Scale Score (NIHSS) was used to assess the severity of neurological impairment in ACI patients, and those with NIHSS <7 were placed into the minor infarction group and those with NIHSS≥7 into the severe infarction group. Serum lncRNA XIST and miR-92a levels were measured at 48 h and/or 14 d after stroke onset, and results were compared between patients of different groups. Pearson correlation and logistic regression analyses were used to evaluate the relationship between lncRNA XIST and miR-92a levels and NIHSS scores. Results: At 48 h after stroke onset, the serum levels of lncRNA XIST were lower and that of miR-92a were higher in infarction group patients compared to those in control group patients (both P<0.05); furthermore, the serum levels of lncRNA XIST in the severe infarction group were lower than that in the minor infarction group while the miR-92a levels in the severe infarction group were higher than that in the minor infarction group (both P<0.01). Compared to 48 h after stroke onset, the lncRNA XIST levels increased while miR-92a levels decreased at 14 d post-stroke (both P<0.01). The serum lncRNA XIST and miR-92a levels in ACI patients were negatively and positively correlated with NIHSS scores, respectively (both P<0.01). Both lncRNA XIST and miR-92a levels were influencing factors of stroke severity in ACI patients. Conclusion: Our results demonstrate a tight correlation between serum lncRNA XIST and miR-92a levels and neurological impairment severity in the early stage of ACI, which may provide a new target for the treatment of ischemic stroke.