颈动脉超声定量参数联合miR-128-3p诊断急性脑梗死的研究

doi:10.7517/issn.1674-0475.221019

摘要/Abstract

摘要： 本研究探讨颈动脉超声定量参数联合微小核糖核酸128-3p （miR-128-3p）在急性脑梗死（ACI）诊断及预后预测中的应用价值。选取120例ACI患者作为观察组，选择100例年龄、性别匹配的健康志愿者作为对照组，通过RT-qPCR法检测两组受试者的外周血miR-128-3p水平，对观察组患者进行颈动脉超声检查，同时比较观察组不同神经功能受损患者和不同预后患者的颈动脉超声定量参数和miR-128-3p水平差异。观察组的外周血miR-128-3p相对表达量高于对照组（P<0.05）。重度受损患者的收缩期峰值血流速度（PSV）明显低于轻度和中度受损患者（P<0.05），而舒张末期血流速度（EDV）、颈总动脉内膜-中层厚度（IMT）及miR-128-3p相对表达量明显高于轻度和中度受损患者（P<0.05）。预后不良患者的PSV低于预后良好患者（P<0.05），而EDV、IMT和miR-128-3p相对表达量高于预后良好患者（P<0.05）。颈动脉超声定量参数联合miR-128-3p预测急性脑梗死预后不良的ROC曲线下面积为0.986，高于各指标单独预测（P<0.05）。PSV、EDV、IMT和miR-128-3p相对表达量与患者神经功能受损程度、预后相关，颈动脉超声定量参数联合miR-128-3p在预测患者预后方面有一定应用价值。

关键词: 颈动脉超声, 微小核糖核酸128-3p, 急性脑梗死, 预后

Abstract: This study investigated the application value of quantitative parameters of carotid ultrasound combined with microRNA 128-3p (miR-128-3p) in the diagnosis and prognosis prediction of acute cerebral infarction(ACI). 120 patients with ACI were selected as the observation group, and 100 healthy volunteers matched for age and gender were selected as the control group. The levels of miR-128-3p in peripheral blood of the two groups were detected by RT-qPCR, and carotid ultrasound examination was performed in the observation group. At the same time, the quantitative parameters of carotid ultrasound and the level of miR-128-3p difference were compared between patients with different neurological impairment and patients with different prognosis in the observation group. The relative expression of miR-128-3p in peripheral blood of the observation group was higher than that of the control group (P<0.05). The peak systolic velocity (PSV) of patients with severe impairment was significantly lower than that of patients with mild and moderate impairment (P<0.05), while the relative expression levels of end diastolic blood flow velocity (EDV), carotid intima-media thickness (IMT) and miR-128-3p were significantly higher than those of patients with mild and moderate impairment (P<0.05). The PSV of patients with poor prognosis was lower than that of patients with good prognosis (P<0.05), while the relative expression levels of EDV, IMT and miR-128-3p were higher than those of patients with good prognosis (P<0.05). The area under the ROC curve of carotid ultrasound quantitative parameters combined with miR-128-3p for predicting poor prognosis of acute cerebral infarction was 0.986, which was higher than that predicted by each index alone (P<0.05). PSV, EDV, IMT and the relative expression of miR-128-3p were related to the degree of neurological impairment and prognosis of patients. Quantitative parameters of carotid ultrasound combined with miR-128-3p have a certain application value in predicting the prognosis of patients.

Key words: carotid ultrasound, microRNA 128-3p, acute cerebral infarction, prognosis

汪宁, 彭兆快. 颈动脉超声定量参数联合miR-128-3p诊断急性脑梗死的研究[J]. 影像科学与光化学, 2023, 41(1): 109-113.

WANG Ning, PENG Zhaokuai. The Study of Quantitative Parameters of Carotid Ultrasound Combined with miR-128-3p in the Diagnosis of Acute Cerebral Infarction[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(1): 109-113.

参考文献

[1] Sun Z, Xu Q, Gao G, et al. Clinical observation in edaravone treatment for acute cerebral infarction[J]. Nigerian Journal of Clinical Practice, 2019, 22(10):1324-1327.
[2] Wu W L, Qiu C F, Feng X W, et al. Protective effect of paeoniflorin on acute cerebral infarction in rats[J]. Current Pharmaceutical Biotechnology, 2020, 21(8):702-709.
[3] Chen J, Zhang W, Wu Y Q, et al. Correlations of acute myocardial infarction complicated by cerebral infarction with insulin resistance, adiponectin and HMGB1[J]. European Review for Medical and Pharmacological Sciences, 2019, 23(10):4425-4431.
[4] Lin P C, Lee C W, Liu H M, et al. Acute infarction in the artery of percheron distribution during cerebral angiography:A case report and literature review[J]. Journal of Radiology Case Reports, 2018, 12(7):1-9.
[5] Toyoda S, Takekawa H, Asakawa Y, et al. Comparison of carotid artery ultrasonography findings between acute coronary syndrome and atherothrombotic cerebral infarction[J]. Journal of Medical Ultrasonics:2001, 2018, 45(1):149-154.
[6] 张力维, 谌雪, 王义成, 等. 超声造影联合三维超声评估颈动脉斑块易损性对急性缺血性脑卒中的预测价值[J]. 河北医科大学学报, 2022, 43(6):706-710.
[7] Geng L J, Zhang T, Liu W, et al. Inhibition of miR-128 abates Aβ-mediated cytotoxicity by targeting PPAR-γ via NF-κB inactivation in primary mouse cortical neurons and Neuro2a cells[J]. Yonsei Medical Journal, 2018, 59(9):1096-1106.
[8] Ma J, Bao L, Xia X, et al. miR-128b promotes cerebral infarction by regulating the expressions of BCL-2 and CAPASE 3[J]. World Neurosurgery, 2019, 123:e245-e251.
[9] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组, 彭斌, 等. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51(9):17.
[10] 张本银, 路吾长, 杨靖. 美国国立卫生研究院卒中量表评分、血浆同型半胱氨酸水平与急性脑梗死的关系及危险因素分析[J]. 实用临床医药杂志, 2021, 25(22):102-105.
[11] 阮志稳. 丁苯酞改善后循环脑梗死患者NIHSS评分、mRS评分、Barthel指数的分析[J]. 心血管病防治知识(学术版), 2019, 9(24):10-11.
[12] Takeda H, Yamaguchi T, Yano H, et al. Microglial metabolic disturbances and neuroinflammation in cerebral infarction[J]. Journal of Pharmacological Sciences, 2021, 145(1):130-139.
[13] Sun W, Li G S, Zeng X J, et al. Clinical and imaging characteristics of cerebral infarction in patients with nonvalvular atrial fibrillation combined with cerebral artery stenosis[J]. Journal of Atherosclerosis and Thrombosis, 2018, 25(8):720-732.
[14] Liang Z, Chi Y J, Lin G Q, et al. MiRNA-26a promotes angiogenesis in a rat model of cerebral infarction via PI3K/AKT and MAPK/ERK pathway[J]. European Review for Medical and Pharmacological Sciences, 2018, 22(11):3485-3492.
[15] 王志, 金庙通, 杨建邦. 脑梗死患者血清miR-181c、miR-128b表达水平及其与90天预后的相关性[J]. 中国动脉硬化杂志, 2019, 27(6):517-521.
[16] 陶珍, 崔连奇, 高丽, 等. 丹参注射液联合尤瑞克林对急性脑梗死患者血清miR-146a、miR-128b表达的影响[J]. 热带医学杂志, 2020, 20(7):928-932.
[17] 李治君, 吴松, 李成, 等. 血清微小RNA-128-3p在下肢动脉硬化闭塞症介入术后支架内再狭窄中的临床意义[J]. 实用临床医药杂志, 2022, 26(10):1-6.
[18] 杨东娜, 张涤, 于佳佳. 丁苯酞注射液联合依达拉奉对老年急性脑梗死患者细胞因子、血管内皮功能和氧化应激的影响[J]. 中国老年学杂志, 2021, 41(3):477-480.
[19] 罗姣, 黄程, 李丹, 等. 高压氧联合早期康复治疗脑卒中的疗效及神经功能恢复的影响因素分析[J]. 解放军预防医学杂志, 2019, 37(4):75-76.