AIS大脑中动脉闭塞患者血清清蛋白、miR-134及mCTA侧支循环评分的临床意义

doi:10.3760/cma.j.cn441417-20250102-12002

摘要/Abstract

摘要：

目的　分析急性缺血性脑卒中（AIS）大脑中动脉闭塞患者血清清蛋白、微小核糖核酸（miR）-134及多时相计算机断层扫描血管成像（mCTA）侧支循环评分对预后的评估价值。方法　采用回顾性分析，选取2022年6月至2024年6月榆林市星元医院收治的124例AIS大脑中动脉闭塞患者病历资料，年龄42~72岁，根据美国国立卫生研究院卒中量表（NIHSS）评分分为轻中度组（59例）与重度组（65例），根据患者发病90 d后的改良Rankin量表（mRS）评分分为预后不良组（mRS评分>2分，46例）与预后良好组（mRS评分≤2分，78例）。比较不同病情程度、不同预后的AIS大脑中动脉闭塞患者血清清蛋白、miR-134水平及mCTA侧支循环评分；采用t检验、χ²检验进行统计比较，受试者操作特征曲线（ROC）分析各指标对AIS大脑中动脉闭塞患者预后的预测效能。结果　重度组血清清蛋白水平及mCTA侧支循环评分分别为（34.13±6.34）g/L、（3.11±0.58）分，低于轻中度组的（40.29±5.80）g/L、（3.90±0.35）分；miR-134水平为4.60±0.93，高于轻中度组的2.58±0.41；差异均有统计学意义（均P<0.05）；预后不良组血清清蛋白水平及mCTA侧支循环评分分别为（35.55±5.94）g/L、（3.28±0.51）分，低于预后良好组的（39.62±6.33）g/L、（3.84±0.40）分；miR-134水平为4.13±0.75，高于预后良好组的2.81±0.57；差异有统计学意义（P<0.05）；ROC分析显示，血清清蛋白、miR-134、mCTA侧支循环评分及联合检测对AIS大脑中动脉闭塞患者预后预测的曲线下面积分别为0.708、0.766、0.807、0.896。结论　AIS大脑中动脉闭塞的预后不良患者血清清蛋白水平及mCTA侧支循环评分更低，miR-134水平更高，以上指标对其预后有较高的预测价值。

关键词: 清蛋白, 微小核糖核酸-134, 多时相计算机断层扫描血管成像, 侧支循环评分, 急性缺血性脑卒中, 预后

Abstract:

Objective　To evaluate the value of serum albumin, microRNA (miR)-134, and multi-temporal computed tomography angiography (mCTA) collateral circulation score for prognosis of patients with cerebral artery occlusion after acute ischemic stroke (AIS). Methods　The medical records of 124 patients with middle artery occlusion after AIS admitted to Yulin Xingyuan Hospital from June 2022 to June 2024 were retrospectively analyzed. The were 42-72 years old. They were divided into a mild to moderate group (59 cases) and a severe group (65 cases) according to the scores of the National Institutes of Health Stroke Scale (NIHSS). According to the scores of the modified Rankin scale (mRS) 90 d after the onset, the patients were divided into a poor prognosis group (mRS score >2; 46 cases) and a good prognosis group (mRS Score ≤2; 78 cases). The serum levels of microRNA-134 and albumin and mCTA collateral circulation scores were compared between the patients with different disease severities and prognoses. t and χ² tests were used for the statistical comparisons. The receiver operating characteristic curve (ROC) was used to analyze the efficacy of each indicator in the prediction of the patients' prognosis. Results　The serum levels of microRNA-134 and albumin and mCTA collateral circulation score in the severe group were (34.13±6.34)g/L, 4.60±0.93, and 3.11±0.58, and those in the the mild to moderate group were (40.29±5.80) g/L, 2.58±0.41, and 3.90±0.35, with statistical differences (all P<0.05). The serum levels of microRNA-134 and albumin and mCTA collateral circulation score in the poor prognosis group were (35.55±5.94) g/L, 4.13±0.75, and 3.28±0.51, and those in the good prognosis group were (39.62±6.33) g/L, 2.81±0.57, and 3.84±0.40, with statistical differences (all P<0.05). The ROC analysis showed that the areas under the curves of serum albumin, miR-134, and mCTA collateral circulation score in predicting the patients' prognosis were 0.708, 0.766, 0.807, and 0.896, respectively. Conclusions　Patients with middle cerebral artery occlusion after AIS who have poor prognosis have higher a serum microRNA-134 level, a lower albumin level, and a lower mCTA collateral circulation score; these indicators have high predictive value for the patients' prognosis.

Key words: , Albumin, , MicroRNA-134, , Multi-temporal computed tomography angiography, , Collateral circulation score, , Acute ischemic stroke, , Prognosis

李建军蒋锋刘小丽. AIS大脑中动脉闭塞患者血清清蛋白、miR-134及mCTA侧支循环评分的临床意义 [J]. 国际医药卫生导报, 2025, 31(12): 1943-1947.

Li Jianjun, Jiang Feng, Liu Xiaoli.

Significance of albumin, miR-134, and mCTA collateral circulation score in patients with cerebral artery occlusion after AIS [J]. International Medicine and Health Guidance News, 2025, 31(12): 1943-1947.

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