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CT 灌注成像参数和血清 miR-106a-5p 预测急性脑梗死患者静脉溶栓后短期和长期预后。

CT perfusion imaging parameters and serum miR-106a-5p predict short- and long-term prognosis in acute cerebral infarction patients after intravenous thrombolysis.

机构信息

Department of Neurology, Yantaishan Hospital, Yantai, Shandong, China.

Department of Neurosurgery, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China.

出版信息

Medicine (Baltimore). 2023 Aug 4;102(31):e34541. doi: 10.1097/MD.0000000000034541.

Abstract

BACKGROUND

Some microRNAs have been found to be abnormal in patients with acute cerebral infarction (ACI) after intravenous thrombolysis. This study aimed to measure the expression of miR-106a-5p in ACI patients before and after thrombolytic treatment, and to investigate the prognostic value of miR-106a-5p and computed tomography perfusion imaging (CTPI) parameters in ACI patients receiving thrombolysis.

METHODS

The levels of serum miR-106a-5p were detected by quantitative real-time PCR in 78 ACI patients before thrombolysis, 24 hours after thrombolysis, and 3 months (90 days) after onset. The correlation of miR-106a-5p with continuous variables were analyzed using Pearson correlation analysis. The association of miR-106a-5p and CTPI parameters with prognosis of patients receiving thrombolysis was evaluated by logistic regression analysis. The accuracy and thresholds of miR-106a-5p and CTPI parameters for discriminating patients with unfavorable prognosis after thrombolysis were assessed by receiver operating characteristic analysis.

RESULTS

Serum miR-106a-5p expression was decreased in ACI patient after thrombolysis. Then, significant correlations of miR-106a-5p with National Institutes of Health Stroke Scale and CTPI parameters were found. Moreover, miR-106a-5p, cerebral blood flow (CBF) and cerebral blood volume (CBV), which are 2 CTPI parameters, were independently correlated with short- and long-term prognosis after thrombolysis. Furthermore, miR-106a-5p, CBF and CBV revealed good accuracy in predicting the prognosis of patients after thrombolysis, and their combination showed the best accuracy.

CONCLUSION

Thrombolysis downregulates miR-106a-5p in ACI patients, and miR-106a-5p, CBF and CBV have considerable potentials to predict short- and long-term prognosis in ACI patients receiving intravenous thrombolysis.

摘要

背景

一些 miRNA 在接受静脉溶栓治疗的急性脑梗死(ACI)患者中异常表达。本研究旨在测量溶栓治疗前后 ACI 患者血清 miR-106a-5p 的表达,并探讨 miR-106a-5p 与 CTPI 灌注参数在接受溶栓治疗的 ACI 患者中的预后价值。

方法

采用实时定量 PCR 检测 78 例 ACI 患者溶栓前、溶栓后 24 小时及发病后 3 个月(90 天)血清 miR-106a-5p 水平。采用 Pearson 相关分析评估 miR-106a-5p 与连续变量的相关性。采用 logistic 回归分析评估 miR-106a-5p 与 CTPI 灌注参数与溶栓患者预后的关系。采用受试者工作特征(ROC)曲线分析 miR-106a-5p 和 CTPI 灌注参数对溶栓后预后不良患者的鉴别诊断价值。

结果

ACI 患者溶栓后血清 miR-106a-5p 表达降低。然后,miR-106a-5p 与 NIHSS 评分和 CTPI 灌注参数显著相关。此外,miR-106a-5p、脑血流量(CBF)和脑血容量(CBV)是 2 个 CTPI 灌注参数,与溶栓后短期和长期预后独立相关。此外,miR-106a-5p、CBF 和 CBV 对预测溶栓后患者预后具有良好的准确性,其组合具有最佳的准确性。

结论

溶栓治疗下调 ACI 患者 miR-106a-5p 的表达,miR-106a-5p、CBF 和 CBV 对预测接受静脉溶栓治疗的 ACI 患者的短期和长期预后具有重要价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f730/10402976/84abd71c2617/medi-102-e34541-g001.jpg

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