动脉粥样硬化型急性脑梗死患者颈动脉斑块特征及血清miR-133b表达分析  

Analysis of carotid plaque characteristics and expression of serum miR-133b in patients with atherosclerotic acute cerebral infarction

作　　者：陈苗苗 李帅[1] 孙岩 熊艳霞[2] CHEN Miao-miao;LI Shuai;SUN Yan;XIONG Yan-xia(Department of Neurological Intensive Care,Zhoukou Central Hospital,Zhoukou,Henan 466000,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]周口市中心医院神经重症监护室,河南周口466000 [2]河南中医药大学第一附属医院,郑州450003

出　　处：《医药论坛杂志》2024年第19期2073-2077,共5页Journal of Medical Forum

基　　金：河南省中医药科学研究专项课题(2016ZY2038)。

摘　　要：目的探讨动脉粥样硬化型急性脑梗死(acute cerebral infarction,ACI)患者颈动脉斑块特征及性质,以期为早期预防提供参考,同时观察血清miR-133b的表达对脑梗死的诊断价值。方法选取2022年1月—2023年12月周口市中心医院收治的动脉粥样硬化型急性脑梗死患者300例为观察组,并选取单纯颈动脉粥样硬化患者100例为对照组,回顾性分析两组不同神经功能缺损程度以及动脉粥样硬化型急性脑梗死患者的颈动脉斑块超声、miR-296-5p和miR-133b水平。结果观察组检测出颈动脉斑块1623个,平均斑块厚度为(1.88±0.27)mm,对照组检测出颈动脉斑块565个,平均斑块厚度为(1.84±0.29)mm,两组平均斑块厚度差异无统计学意义(P>0.05);观察组miR-133b的表达量为0.05(0.02,0.20),与对照组0.56(0.37,1.03)比较,差异有统计学意义(P<0.05);观察组miR-296-5p的表达量为0.96(0.42,2.39),与对照组0.33(0.11,4.07)比较,差异无统计学意义(P>0.05);中重度神经功能缺损组检测出颈动脉斑块552个,平均斑块厚度为(1.85±0.24)mm,中度神经功能缺损组检测出颈动脉斑块1058个,平均斑块厚度为(1.90±0.30)mm,两组平均斑块厚度差异无统计学意义(P>0.05);中重度神经功能缺损组患者的混合回声、不规则形态率高于中度神经功能缺损组(P<0.05)。将两组数据置入SPSS软件ROC分类中的状态变量栏,以miR-296-5p、miR-133b两个因子作为检验变量,绘制ROC曲线下面积AUC以及所对应的95%置信区间,筛选出最大值对应的最佳截断值,AUC表示对疾病预测准确率的高低,值越大准确率越高,miR-133b的AUC值为0.871,高于miR-296-5p的AUC值0.437,提示miR-133b预测价值更高。结论动脉粥样硬化型急性脑梗死患者颈动脉斑块特征主要为形态不规则以及混合性回声,性质一般为易损斑块,颈动脉易损斑块破裂是发生急性脑梗死事件的重要危险因素。miR-133b与病情严重程度呈负相关,且可能作为诊断ACI潜Objective To investigate the characteristics and properties of carotid plaque in patients with atherosclerotic acute cerebral infarction,in order to provide reference for early prevention,and to observe the value of serum miR-133b expression in the diagnosis of cerebral infarction.Methods A total of 300 patients with atherosclerotic acute cerebral infarction admitted to Zhoukou Central Hospital from January 2022 to December 2023 were selected as the observation group,and 100 patients with simple carotid atherosclerosis were selected as the control group.Carotid plaque ultrasound,miR-296-5p and miR-133b levels of patients with different degree of neurological impairment and atherosclerotic acute cerebral infarction in two groups were retrospectively analyzed.Results There were 1623 carotid plaque detected in the observation group,the average plaque thickness was(1.88±0.27)mm,and 565 carotid plaque detected in the control group,the average plaque thickness was(1.84±0.29)mm.There was no statistical significance between the two groups(P>0.05).The expression level of miR-133b in the observation group was 0.05(0.02,0.20),which was significantly higher than that in the control group 0.56(0.37,1.03)(P<0.05).The expression level of miR-296-5p in the observation group was 0.96(0.42,2.39),which had no statistical significance compared with that in the control group 0.33(0.11,4.07)(P>0.05).552 carotid plaques were detected in the moderate and severe neurological impairment group,with an average plaque thickness of(1.85±0.24)mm,and 1058 carotid plaques were detected in the moderate neurological impairment group,with an average plaque thickness of(1.90±0.30)mm,with no statistically significant difference between the two groups(P>0.05).The rate of mixed echo and irregular shape in moderate and severe neurological impairment group was higher than that in moderate neurological impairment group(P<0.05).The two groups of data were placed in the state variable column of the ROC classification in SPSS software,and the two factors

关 键 词：动脉粥样硬化 急性脑梗死 颈动脉斑块特征 微小RNA 

分 类 号：R743[医药卫生—神经病学与精神病学]