中国现代医学杂志2023，Vol.33Issue(24)：67-73,7.DOI:10.3969/j.issn.1005-8982.2023.24.012
mCTA侧支循环评分及血清microRNA-134、VEGF、bFGF水平预测AIS大脑中动脉闭塞患者预后的价值
Value of mCTA collateral score and serum levels of microRNA-134,VEGF and bFGF in predicting clinical prognosis of AIS patients with middle cerebral artery occlusion
摘要
Abstract
Objective To explore the value of multiphase computed tomography angiography(mCTA)collateral score and serum levels of microRNA-134,vascular endothelial growth factor(VEGF),and basic fibroblast growth factor(bFGF)in predicting the clinical outcome of acute ischemic stroke(AIS)patients with middle cerebral artery occlusion.Methods A total of 108 AIS patients with middle cerebral artery occlusion treated in our hospital from February 2020 to February 2023 were included in the study.The mCTA collateral score was measured and serum levels of microRNA-134,VEGF and bFGF were detected during treatment,and the patients were followed up.According to the modified Rankin Scale score 3 months after discharge from hospital,patients were divided into the good prognosis group(modified Rankin scale score ≤ 2 points,n=47)and poor prognosis group(modified Rankin scale score＞2,n=61).The factors that may affect the prognosis of patients were analyzed,and the diagnostic value of these indicators was explored via the receiver operating characteristic(ROC)curve.Results The final infarct volume in the poor prognosis group was larger than that in the good prognosis group(P＜0.05),and the mCTA collateral score in the poor prognosis group was lower than that in the good prognosis group(P＜0.05).The relative expression of microRNA-134 in the poor prognosis group was higher than that in the good prognosis group(P＜0.05),and the levels of VEGF and bFGF in the poor prognosis group were lower than those in the good prognosis group(P＜0.05).The age and the level of low-density lipoprotein in the poor prognosis group were higher than those in the good prognosis group(P＜0.05).Multivariable Logistic regression analysis exhibited that the mCTA collateral score[(OR)=1.003(95％CI:-0.327,-0.016)]and levels of microRNA-134[(OR)=1.066(95％CI:0.030,0.099)],VEGF[(OR)=0.998(95％CI:-0.003,-0.002)],bFGF[(OR)=0.998(95％CI:-0.002,-0.001)]and low-density lipoprotein[(OR)=1.075(95％CI:0.029,0.115)]were factors affecting the prognosis of AIS patients with middle cerebral artery occlusion(P＜0.05).As suggested by the ROC curve analysis,the areas under the curves of the mCTA collateral score and serum levels of microRNA-134,VEGF and bFGF in predicting the poor prognosis of AIS patients with middle cerebral artery occlusion were 0.843,0.946,0.937 and 0.892,with the sensitivities being 76.6％(95％CI:0.695,0.837),93.6％(95％CI:0.900,0.972),87.2％(95％CI:0.823,0.921),and 72.3％(95％CI:0.661,0.785),and the specificities being 83.6％(95％CI:0.770,0.902),82.0％(95％CI:0.770,0.870),86.9％(95％CI:0.818,0.920),and 93.4％(95％CI:0.896,0.972).Conclusions In patients with poor prognosis,the final infarct volume is larger,and the mCTA collateral score and serum levels of microRNA-134,VEGF and bFGF are lower.The mCTA collateral score and serum levels of microRNA-134,VEGF,and bFGF are of great predictive value for poor prognosis in AIS patients with middle cerebral artery occlusion,and can be therefore established as prognostic factors.关键词
多时相计算机断层扫描血管成像/侧支循环评分/microRNA-134/血管内皮细胞生长因子/碱性成纤维细胞生长因子/急性缺血性脑卒中/动脉闭塞/预后Key words
multiphase computed tomography angiography/collateral score/microRNA-134/vascular endothelial growth factor/basic fibroblast growth factor/acute ischemic stroke/arterial occlusion/prognosis分类
医药卫生引用本文复制引用
曹德峰,陈文亚,马爱金,吴婧,吴波娜..mCTA侧支循环评分及血清microRNA-134、VEGF、bFGF水平预测AIS大脑中动脉闭塞患者预后的价值[J].中国现代医学杂志,2023,33(24):67-73,7.基金项目
江苏省自然科学基金(No:BK20201118) （No:BK20201118）
常州市武进区科技计划项目(No:WS201921) （No:WS201921）
