CT脑灌注成像参数联合血清miR-103、miR-106a-5p对急性缺血性脑卒中患者预后不良的预测价值OA
Predictive value of CT cerebral perfusion imaging parameters combined with serum miR-103 and miR-106a-5p for poor prognosis in patients with acute ischemic stroke
目的 探讨 CT 脑灌注成像参数联合血清微小 RNA-103(miR-103)、微小 RNA-106a-5p(miR-106a-5p)对急性缺血性脑卒中(AIS)患者预后不良的预测价值.方法 选取2021年12月至2024年12月在该院治疗的146例AIS患者作为研究对象,依据患者病情严重程度分为轻症组、中症组、重症组.治疗前,对患者进行CT脑灌注成像检查并获取平均通过时间(MTT)和达峰时间(TTP).根据治疗3个月后的短期预后评估结果,将AIS患者分为预后良好组、预后不良组.治疗前采用实时荧光定量聚合酶链反应检测患者血清 miR-103、miR-106a-5p表达水平.比较患者基线资料.采用多因素Logistic回归分析 AIS患者预后不良的相关因素.采用受试者工作特征(ROC)曲线分析血清 miR-103、miR-106a-5p、MTT、TTP对 AIS患者预后不良的预测价值.结果 重症组血清 miR-103、miR-106a-5p表达水平高于轻症组、中症组,MTT、TTP长于轻症组、中症组,且中症组血清 miR-103、miR-106a-5p表达水平高于轻症组,MTT、TTP长于轻症组,差异均有统计学意义(P<0.05).预后不良组血清 miR-103、miR-106a-5p表达水平,入院时美国国立卫生研究院卒中量表(NIH-SS)评分高于预后良好组,MTT、TTP长于预后良好组,病灶最大径大于预后良好组,差异均有统计学意义(P<0.05).血清 miR-103、miR-106a-5p、入院时 NIHSS评分、MTT、TTP为 AIS患者预后不良的相关因素(P<0.05).MTT、TTP、血清 miR-103、miR-106a-5p及4项联合预测 AIS患者预后不良的曲线下面积(AUC)分别为0.876、0.825、0.830、0.791、0.937,联合预测的 AUC大于各指标单独预测的 AUC(Z联合-MTT=2.182、P=0.029,Z联合-TTP=2.734、P=0.006,Z联合-miR-103=2.643、P=0.008,Z联合-miR-106a-5p=4.003、P<0.001).结论 AIS患者血清 miR-103、miR-106a-5p表达水平明显升高,miR-103、miR-106a-5p与病情严重程度及短期预后有着紧密联系,CT脑灌注成像参数联合血清 miR-103、miR-106a-5p对AIS患者预后不良有较高的预测价值.
Objective To investigate the predictive value of CT cerebral perfusion imaging parameters com-bined with serum microRNA-103(miR-103)and microRNA-106a-5p(miR-106a-5p)for poor prognosis in pa-tients with acute ischemic stroke(AIS).Methods A total of 146 patients with AIS treated in the hospital from December 2021 to December 2024 were selected as the study subjects and divided into a mild group,a moderate group and a severe group according to the severity of the disease.Before treatment,all patients un-derwent CT cerebral perfusion imaging,and mean transit time(MTT)and time to peak(TTP)were ob-tained.Based on the short-term prognosis assessment at 3 months after treatment,the patients were divided into a good prognosis group and a poor prognosis group.Prior to treatment,the serum expression levels of miR-103 and miR-106a-5p were measured by quantitative real-time polymerase chain reaction.Baseline data of the patients were compared.Multivariate Logistic regression analysis was performed to identify the factors as-sociated with poor prognosis in patients with AIS.Receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of serum miR-103,miR-106a-5p,MTT and TTP for poor prognosis in patients with AIS.Results The expression levels of serum miR-103 and miR-106a-5p in the severe group were higher than those in the mild and moderate groups,and MTT and TTP in the severe group were longer than those in the mild and moderate groups;additionally,the expression levels of serum miR-103 and miR-106a-5p in the moderate group were higher than those in the mild group,and MTT and TTP in the moderate group were lon-ger than those in the mild group,and the differences were statistically significant(P<0.05).The expression levels of serum miR-103 and miR-106a-5p,and the National Institutes of Health Stroke Scale(NIHSS)score at admission in the poor prognosis group were higher than those in the good prognosis group,MTT and TTP were longer than those in the good prognosis group,and the maximum lesion diameter was larger than that in the good prognosis group,and the differences were statistically significant(P<0.05).Serum miR-103,miR-106a-5p,NIHSS score at admission,MTT,and TTP were identified as factors associated with poor prognosis in AIS patients(P<0.05).The areas under the curve(AUCs)of MTT,TTP,serum miR-103,serum miR-106a-5p,and the combination of the four indicators for predicting poor prognosis in AIS patients were 0.876,0.825,0.830,0.791,and 0.937 respectively.The AUC of the combined prediction was significantly greater than that of each individual indicator(Zcombination vs.MTT=2.182,P=0.029;Zcombination vs.TTP=2.734,P=0.006;Zcombination vs.miR-103=2.643,P=0.008;Zcombination vs.miR-106a-5p=4.003,P<0.001).Conclusion The expression lev-els of serum miR-103 and miR-106a-5p are significantly elevated in AIS patients.MiR-103 and miR-106a-5p are closely associated with disease severity and short-term prognosis.CT cerebral perfusion imaging parame-ters combined with serum miR-103 and miR-106a-5p demonstrate higher predictive value for poor prognosis in AIS patients.
张嘉茜;胡纳新;周毅;侯波;支建梅;武文平
北京中医药大学东方医院秦皇岛医院 影像科,河北 秦皇岛 066000北京中医药大学东方医院秦皇岛医院 影像科,河北 秦皇岛 066000北京中医药大学东方医院秦皇岛医院 影像科,河北 秦皇岛 066000北京中医药大学东方医院秦皇岛医院 影像科,河北 秦皇岛 066000北京中医药大学东方医院秦皇岛医院 脑病二科,河北 秦皇岛 066000北京中医药大学东方医院秦皇岛医院 检验科,河北 秦皇岛 066000
医药卫生
微小RNA-103微小RNA-106a-5p急性缺血性脑卒中CT脑灌注成像预后不良
microRNA-103microRNA-106a-5pacute ischemic strokeCT cerebral perfusion ima-gingpoor prognosis
《检验医学与临床》 2026 (12)
1707-1713,7
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