机构地区:[1]丽水市第二人民医院康复科,浙江丽水323000
出 处:《中国现代医生》2024年第18期53-57,共5页China Modern Doctor
摘 要:目的研究miR-181a、半乳凝素-3(galectin-3,GAL3)在急性缺血性脑卒中(acute ischemic stroke,AIS)病情及预后评估中的临床价值。方法选取2019年1月至2021年1月诊治的82例AIS患者(AIS组)和40例同期无缺血性脑卒中的颅脑血管疾病患者(对照组)为研究对象,比较两组患者的血清miR-181a、GAL3、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、改良Barthel指数评定量表(modified Barthel index,MBI)及Fugl-Meyer肢体运动功能(Fugl-Meyer assessment of gait,FMA)评分的差异。Pearson相关性分析miR-181a、GAL3与神经功能指标(NIHSS、MBI、FMA评分)的相关性。采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析miR-181a、GAL3预测AIS患者1年预后不良的效能。Logistic回归分析AIS患者1年死亡的危险因素。结果与对照组比较,AIS组患者的miR-181a、GAL3、NIHSS评分显著增高(P<0.05);MBI及FMA评分均显著降低(P<0.05)。AIS组患者的miR-181a、GAL3与NIHSS评分呈正相关(r>0,P<0.05);与MBI评分、FMA评分呈负相关(r<0,P<0.05)。miR-181a、GAL3预测AIS组患者1年预后不良的敏感度、特异性、曲线下面积(areaunder the curve,AUC)均高于NIHSS评分、MBI评分、FMA评分;miR-181a联合GAL3预测AIS组患者1年预后不良的敏感度、特异性、AUC均高于miR-181a、GAL3、NIHSS评分、MBI评分、FMA评分。miR-181a≥1.3、GAL3≥12.3ng/ml、NIHSS评分≥17.4分、MBI评分<67.6分、FMA评分<84.2分为AIS患者1年死亡的独立危险因素(P<0.05)。结论AIS患者血清miR-181a及GAL3水平明显增高,在AIS病情及预后评估中具有一定的临床价值。Objective To study the clinical value of miR-181a and galectin-3(GAL3)in the assessment of the condition and prognosis of acute ischemic stroke(AIS).Methods A total of 82 AIS patients(AIS group)diagnosed and treated from January 2019 to January 2021 and patients with cerebrovascular disease without ischemic stroke during the same period(control group)were selected as the research subjects,and the serum miR-181a,GAL3,National Institute of Health stroke scale(NIHSS),modified Barthel index(MBI)and Fugl-Meyer assessment of gait(FMA)of the two groups were compared.Pearson correlation analysis was performed on the correlation between miR-181a,GAL3 and neurological function indicators(NIHSS,MBI,FMA score).Receiver operating characteristic curve(ROC)was used to analyze the effectiveness of miR-181a and GAL3 in predicting poor 1-year prognosis in AIS patients.Logistic regression analysis of risk factors for 1-year death in postmenstrual AIS patients.Results Compared with control group,the miR-181a,GAL3,and NIHSS scores of patients in AIS group were significantly higher(P<0.05),and the MBI score and FMA score were significantly lower(P<0.05).In AIS group,patients’miR-181a and GAL3 were positively correlated with the NIHSS score(r>0,P<0.05),and were negatively correlated with the MBI score and FMA score(r<0,P<0.05).The sensitivity,specificity,and area under the curve(AUC)of miR-181a and GAL3 in predicting poor 1-year prognosis of AIS patients in the AIS group are higher than the NIHSS score,MBI score,and FMA score;The sensitivity of miR-181a combined with GAL3 in predicting poor 1-year prognosis in patients in AIS group,specificity,and AUC were all higher than miR-181a,GAL3,NIHSS score,MBI score,and FMA score.miR-181a≥1.3,GAL3≥12.3ng/ml,NIHSS score≥17.4 points,MBI score<67.6 points,and FMA score<84.2 points were independent risk factors for 1-year death in AIS patients(P<0.05).Conclusion The serum levels of miR-181a and GAL3 in AIS patients are significantly increased,which have certain clinical value in the evaluat
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