颈动脉超声高分辨MRI联合血清miR-27a预测颈动脉支架植入术后抗血小板治疗患者预后的价值OACSTPCD
Value of carotid artery ultrasound and high-resolution MRI parameters combined with serum miR-27a in predicting the prognosis of patients with carotid artery stenosis after surgery
目的 探讨颈动脉超声、高分辨MRI参数联合血清miR-27a预测颈动脉狭窄患者经颈动脉支架植入术后抗血小板治疗预后的价值.方法 纳入2021-01-2022-12于大庆龙南医院接受颈动脉支架植入术及抗血小板治疗的110例颈动脉狭窄患者.术前采用彩色多普勒超声诊断仪对所有研究对象进行检查,测定并记录平均血流速度(MFV)、舒张末期最低血流速度(EDV)、最大血流速度(PSV)及颈动脉狭窄率,采用高分辨MRI检查并记录患者的斑块偏心指数和斑块强化程度,应用荧光定量PCR检测血清miR-27a水平.患者出院后随访1a,观察预后情况,分为预后良好组和预后不良组.结果 110例患者中预后良好者83例,预后不良者27例.预后良好组和预后不良组患者性别、年龄、身高、体质量、吸烟史、饮酒史情况比较均无统计学差异(P＞0.05).预后良好组患者的PSV、斑块强化程度和血清miR-27a水平与预后不良组相比显著降低(P＜0.05).颈动脉狭窄患者MFV和PSV与血清miR-27a水平呈显著正相关(P＜0.05),颈动脉狭窄患者的MFV、EDV、PSV、斑块偏心指数、斑块强化程度和血清miR-27a水平均与颈动脉狭窄率呈显著正相关(P＜0.05).PSV、斑块强化程度和血清miR-27a水平预测颈动脉狭窄患者预后的AUC分别为0.764(95%CI:0.662～0.866)、0.649(95%CI:0.519～0.779)和0.832(95%CI:0.748～0.916).PSV、斑块强化程度联合血清miR-27a预测颈动脉狭窄患者预后的AUC为0.895(95%CI:0.830～0.960).结论 颈动脉超声、高分辨MRI参数联合血清miR-27a对颈动脉狭窄术后患者的预后预测具有一定价值.
Objective To investigate the prognostic value of carotid ultrasound and high-resolution MRI parameters combined with serum miR-27a in predicting the prognosis of patients with carotid artery stenosis after carotid stent implantation.Methods A total of 110 patients with carotid artery stenosis who received carotid stent implantation and postoperative antiplatelet therapy in Daqing Longnan Hospital from January 2021 to December 2022 were included.All subjects were examined by color Doppler ultrasonography before surgery,and the mean flow velocity(MFV),end diastolic velocity(EDV),peak systolic velocity(PSV)and carotid artery stenosis rate were measured and recorded.The plaque eccentricity index and plaque enhancement degree of patients were examined by high-resolution MRI.Serum miR-27a levels were detected by fluorescence quantitative PCR.The patients were followed up for 1 year after discharge to observe their prognosis,and were divided into good prognosis group and bab prognosis group.Results Among the 110 patients,83 had good prognosis and 27 had bab prognosis.There were no significant differences in gender,age,height,weight,smoking history and drinking history between the good prognosis group and the bad prognosis group(P>0.05).PSV,plaque enhancement and serum miR-27a in the good prognosis group were significantly decreased compared with those in the poor prognosis group(P<0.05).There was a significant positive correlation between MFV and PSV and serum miR-27a levels in patients with carotid artery stenosis(P<0.05).MFV,EDV,PSV,plaque eccentricity index,plaque enhancement degree and serum miR-27a level in patients with carotid artery stenosis were significantly positively correlated with carotid artery stenosis rate(P<0.05).The AUC of PSV,plaque enhancement degree and serum miR-27a level in predicting prognosis of patients with carotid artery stenosis were 0.764(95%CI:0.662-0.866),0.649(95%CI:0.519-0.779)and 0.832(95%CI:0.748-0.916),respectively.The AUC of PSV and plaque enhancement combined with serum miR-27a predicted the prognosis of patients with carotid artery stenosis was 0.895(95%CI:0.830-0.960).Conclusion Carotid ultrasound and high-resolution MRI parameters combined with serum miR-27a have a certain value in predicting the prognosis of patients with carotid artery stenosis after surgery.
杨静;张玲;李秀岩;周欣彤
大庆龙南医院,黑龙江 大庆 163453
临床医学
颈动脉狭窄颈动脉超声高分辨磁共振miR-27a预后
Carotid artery stenosisCarotid ultrasoundHigh-resolution MRImiR-27aPrognosis
《中国实用神经疾病杂志》 2024 (001)
48-53 / 6
大庆市指导性科技计划项目(编号:zdy-2019-17)
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