SMI技术联合血清miR-217-5p诊断进展性缺血性脑卒中的研究

doi:10.7517/issn.1674-0475.221023

摘要/Abstract

摘要： 本研究考察超微血流成像（SMI）技术联合血清miR-217-5p诊断进展性缺血性脑卒中的价值。选择121例急性缺血性脑卒中患者作为研究对象，参照欧洲进展性卒中研究组相关诊断标准将患者分为非进展组（73例）和进展组（48例）。所有患者均进行SMI检查。另外，选择20例男性和10例女性健康体检者作为对照组。通过RT-qPCR检测受试者血清miR-217-5p水平。结果显示，进展组（50.00%）患者颈动脉重度狭窄率高于非进展组（20.55%），P<0.001。进展组患者的SMI分值高于非进展组（P<0.001）。与对照组相比，非进展组和进展组的血清miR-217-5p相对表达量均降低，且进展组低于非进展组（P<0.001）。血清miR-217-5p水平与狭窄程度负相关（r=－0.247，P=0.006），SMI分值与狭窄程度正相关（r=0.427，P<0.001）。血清miR-217-5p水平和SMI分值联合诊断进展性缺血性脑卒中的ROC曲线下面积（AUC）和特异性高于单独诊断。血清miR-217-5p联合SMI分值诊断进展性缺血性脑卒中的准确性高于两项指标的单独诊断。

关键词: 超微血流成像, miR-217-5p, 进展性缺血性脑卒中, 颈动脉狭窄

Abstract: This study investigated the value of superb microvascular imaging (SMI) combined with serum miR-217-5p in the diagnosis of progressive ischemic stroke. 121 patients with acute ischemic stroke were selected as the research subjects, and the patients were divided into a non-progressive group (73 cases) and a progressive group (48 cases) according to the relevant diagnostic criteria of the European Progressive Stroke Study Group. All patients underwent SMI examination. In addition, 20 male and 10 female healthy subjects were selected as the control group. Serum miR-217-5p levels of subjects were detected by RT-qPCR. The results showed that the rate of severe carotid artery stenosis of patients in the progressive group (50.00%) was higher than that in the non-progressive group (20.55%), P<0.001. The SMI scores of patients in the progression group were higher than those in the non-progression group (P<0.001). Compared with the control group, the relative expression of serum miR-217-5p in the non-progressive and progressive groups were both decreased, and the progressive group was lower than that in the non-progressive group (P<0.001). Serum miR-217-5p level was negatively correlated with stenosis degree (r=-0.247, P=0.006), SMI score was positively correlated with stenosis degree (r=0.427,P<0.001). The area under the ROC curve (AUC) and specificity of the combination of serum miR-217-5p level and SMI score in the diagnosis of progressive ischemic stroke were higher than those of single diagnosis. The accuracy of serum miR-217-5p combined with SMI score in the diagnosis of progressive ischemic stroke is higher than that of the two indicators alone.

Key words: ultra-micro blood flow imaging, MiR-217-5p, progressive ischemic stroke, carotid artery stenosis

郑丽娜, 解小双, 骆周展, 唐奇. SMI技术联合血清miR-217-5p诊断进展性缺血性脑卒中的研究[J]. 影像科学与光化学, 2023, 41(1): 69-73.

ZHENG Li'na, XIE Xiaoshuang, LUO Zhouzhan, TANG Qi. Study of SMI Technique Combined with Serum miR-217-5p in the Diagnosis of Progressive Ischemic Stroke[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(1): 69-73.

参考文献

[1] Campbell B C V, De Silva D A, Macleod M R, et al. Ischaemic stroke[J]. Nature Reviews Disease Primers, 2019, 5(1):70.
[2] Caprio F Z, Sorond F A. Cerebrovascular disease:Primary and secondary stroke prevention[J]. The Medical Clinics of North America, 2019, 103(2):295-308.
[3] Mannelli L, Mitsumori L M, Ferguson M, et al. Changes in measured size of atherosclerotic plaque calcifications in dual-energy CT of ex vivo carotid endarterectomy specimens:Effect of monochromatic keV image reconstructions[J]. European Radiology, 2013, 23(2):367-374.
[4] Soeda T, Uemura S, Morikawa Y, et al. Diagnostic accuracy of dual-source computed tomography in the characterization of coronary atherosclerotic plaques:Comparison with intravascular optical coherence tomography[J]. International Journal of Cardiology, 2011, 148(3):313-318.
[5] 王文峰, 常叶, 牟荣骥. 超微血流成像技术诊断缺血性脑卒中患者颈动脉狭窄的应用价值[J]. 影像科学与光化学, 2020, 38(5):807-810.
[6] 张硕, 马燕, 冯娟. 超微血流成像对进展性缺血性卒中的判断价值[J]. 中国脑血管病杂志, 2016, 13(8):393-397.
[7] 曾卓华, 吴垠, 代文雪. 超微血流成像评价阿托伐他汀对颈动脉斑块内新生血管的影响[J]. 中国实用神经疾病杂志, 2021, 24(11):961-965.
[8] 陈泳生, 贺迎. 应用超微血流成像评价颈动脉斑块新生血管[J]. 临床心电学杂志, 2020, 29(5):360-362.
[9] 顾婷, 管义祥, 殷晓慧. 超微血流成像评价颈动脉斑块易损性的临床价值[J]. 中西医结合心脑血管病杂志, 2021, 19(13):2268-2272.
[10] Duan X C, Gan J H, Peng D Y, et al. Identification and functional analysis of microRNAs in rats following focal cerebral ischemia injury[J]. Molecular Medicine Reports, 2019, 19(5):4175-4184.
[11] 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南2010[J]. 中国全科医学, 2011, 14(35):4013-4017.
[12] Birschel P, Ellul J, Barer D. Progressing stroke:Towards an internationally agreed definition[J]. Cerebrovascular Diseases:Basel, Switzerland, 2004, 17(2-3):242-252.
[13] Mozzini C, Roscia G, Casadei A, et al. Searching the perfect ultrasonic classification in assessing carotid artery stenosis:Comparison and remarks upon the existing ultrasound criteria[J]. Journal of Ultrasound, 2016, 19(2):83-90.
[14] 勇强, 张蕾, 袁嘉, 等. 超微血流成像技术诊断颈动脉斑块新生血管的价值[J]. 中国超声医学杂志, 2014, 30(12):1060-1063.
[15] Barnett H J M, Taylor D W, Haynes R B, et al. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis[J]. The New England Journal of Medicine, 1991, 325(7):445-453.
[16] 谢霞, 白志勇, 刘悦, 等. 超微血流成像技术在颈动脉易损斑块诊断中的应用价值[J]. 中国医学科学院学报, 2018, 40(4):444-449.
[17] Bai M, Zhang M Z, Long F, et al. MiR-217 promotes cutaneous squamous cell carcinoma progression by targeting PTRF[J]. American Journal of Translational Research, 2017, 9(2):647-655.
[18] Dai Z P, Jin Y, Zheng J, et al. MiR-217 promotes cell proliferation and osteogenic differentiation of BMSCs by targeting DKK1 in steroid-associated osteonecrosis[J]. Biomedicine & Pharmacotherapy, 2019, 109:1112-1119.
[19] Flum M, Kleemann M, Schneider H, et al. miR-217-5p induces apoptosis by directly targeting PRKCI, BAG3, ITGAV and MAPK1 in colorectal cancer cells[J]. Journal of Cell Communication and Signaling, 2018, 12(2):451-466.
[20] Gao Y, Wang B, Luo H, et al. miR-217 represses TGF-β1-induced airway smooth muscle cell proliferation and migration through targeting ZEB1[J]. Biomedicine & Pharmacotherapy, 2018, 108:27-35.
[21] Yang X S, Li D N, Qi Y Z, et al. MicroRNA-217 ameliorates inflammatory damage of endothelial cells induced by oxidized LDL by targeting EGR1[J]. Molecular and Cellular Biochemistry, 2020, 475(1-2):41-51.
[22] Magyar M T, Bereczki D, Csípo I, et al. Elevated white blood cell count, CRP and fibrinogen levels are not associated with increased anti-endothelial and anti-ox-LDL antibody, MCP-1, and RANTES levels in early onset occlusive carotid artery disease[J]. Cytokine, 2007, 37(1):44-50.
[23] Harja E, Bucciarelli L G, Lu Y, et al. Early growth response-1 promotes atherogenesis:Mice deficient in early growth response-1 and apolipoprotein E display decreased atherosclerosis and vascular inflammation[J]. Circulation Research, 2004, 94(3):333-339.
[24] Liu K L, Yang Y C, Yao H T, et al. Docosahexaenoic acid inhibits inflammation via free fatty acid receptor FFA4, disruption of TAB2 interaction with TAK1/TAB1 and downregulation of ERK-dependent Egr-1 expression in EA.hy926 cells[J]. Molecular Nutrition & Food Research, 2016, 60(2):430-443.
[25] Pagel J I, Ziegelhoeffer T, Heil M, et al. Role of early growth response 1 in arteriogenesis:Impact on vascular cell proliferation and leukocyte recruitment in vivo[J]. Thrombosis and Haemostasis, 2012, 107(3):562-574.
[26] Davies P F, Civelek M, Fang Y, et al. The atherosusceptible endothelium:Endothelial phenotypes in complex haemodynamic shear stress regions in vivo[J]. Cardiovascular Research, 2013, 99(2):315-327.
[27] Zhang X, Wang Z, Li W, et al. MicroRNA-217-5p ameliorates endothelial cell apoptosis induced by ox-LDL by targeting CLIC₄[J]. Nutrition, Metabolism, and Cardiovascular Diseases, 2020, 30(3):523-533.