摘要
目的探究高分辨率磁共振成像(高分辨率MR)联合血清微小核糖核酸-140-3p(miR-140-3p)、微小核糖核酸-223-3p(miR-223-3p)在颈动脉粥样硬化斑块易损性评价中的价值。方法选取2022年1月—2023年12月连云港市第一人民医院神经内科收治的颈动脉粥样硬化患者86例为研究对象,根据病理学确诊斑块状况将患者分为斑块易损组42例和非斑块易损组44例。采用实时荧光定量PCR(qRT-PCR)法检测血清miR-140-3p、miR-223-3p表达;Kappa检验分析高分辨率MR检测与金标准诊断颈动脉粥样硬化斑块易损的一致性;多因素Logistic回归分析颈动脉粥样硬化患者斑块易损的影响因素;受试者工作特征(ROC)曲线分析高分辨率MR、miR-140-3p、miR-223-3p对颈动脉粥样硬化患者斑块易损性的诊断价值。结果斑块易损组血清miR-140-3p表达低于非斑块易损组,血清miR-223-3p表达高于非斑块易损组(t/P=6.033/<0.001,6.367/<0.001);2组动脉重构类型及斑块分布位置比较,差异无统计学意义(P>0.05);Kappa检验显示,高分辨率MR检测与金标准诊断颈动脉粥样硬化斑块易损的一致性尚可(Kappa=0.603,P<0.001);多因素Logistic回归分析显示,C反应蛋白(CRP)、miR-223-3p升高为颈动脉粥样硬化患者斑块易损的独立危险因素[OR(95%CI)=1.685(1.051~2.702)、3.054(2.008~4.645)],miR-140-3p升高为独立保护因素[OR(95%CI)=0.752(0.616~0.918)];高分辨率MR、miR-140-3p、miR-223-3p及三者联合诊断颈动脉粥样硬化患者斑块易损性的曲线下面积(AUC)分别为0.800、0.860、0.884、0.981,三者联合的AUC大于高分辨率MR、miR-140-3p、miR-223-3p单独诊断的AUC(Z/P=4.537/<0.001、2.980/0.003、2.869/0.004)。结论高分辨率MR联合血清miR-140-3p、miR-223-3p检测对颈动脉粥样硬化斑块易损性有较高的诊断价值。
Objective To explore the value of high-resolution magnetic resonance imaging(high-resolution MR)combined with serum micrornA-140-3p(miR-140-3p)and micrornA-223-3p(miR-223-3p)in the assessment of the vulnerability of carotid atherosclerotic plaques.Methods A total of 86 patients with carotid atherosclerosis admitted to the Department of Neurology of the First People's Hospital of Lianyungang City from January 2022 to December 2023 were selected as the study objects.According to the pathologically confirmed plaque status,the patients were divided into a plaque vulnerable group(42 cases)and a non-plaque vulnerable group(44 cases).The serum levels of miR-140-3p and miR-223-3p were detected by real-time fluorescence quantitative PCR(qRT-PCR).Kappa test was used to analyze the consistency of high-resolution MR Detection and gold standard in diagnosing vulnerable carotid atherosclerotic plaques.Multivariate Logistic regression was used to analyze the influencing factors of plaque vulnerability in patients with carotid atherosclerosis.Receiver operating characteristic(ROC)curve analysis of the diagnostic value of high-resolution MR,miR-140-3p and miR-223-3p in plaque vulnerability in patients with carotid atherosclerosis.Results The serum miR-140-3p level in the plaque vulnerable group was lower than that in the non-plaque vulnerable group,and the serum miR-223-3p level was higher than that in the non-plaque vulnerable group(t/P=6.033/<0.001,6.367/<0.001).There was no significant difference in arterial remodeling type and plaque distribution between the two groups(P>0.05).Kappa test showed that the high resolution MR Test was generally consistent with the gold standard in the diagnosis of vulnerable carotid atherosclerotic plaque(Kappa value=0.603).Multivariate Logistic regression analysis showed that high CRP and miR-223-3p were independent risk factors for vulnerable plaque in patients with carotid atherosclerosis[OR(95%CI)=1.685(1.051-2.702),3.054(2.008-4.645)].The high level of miR-140-3p was an independent protective factor[OR(95%CI)=0.752(0.616-0.918)].The area under the curve(AUC)of plaque vulnerability in patients with carotid atherosclerosis diagnosed by high-resolution MR,miR-140-3p,miR-223-3p and their combination were 0.800,0.860,0.884 and 0.981,respectively.The AUC of the combination of the three was greater than that diagnosed by high-resolution MR,miR-140-3p and miR-223-3p alone(Z/P=4.537/<0.001,2.980/0.003,2.869/0.004).Conclusion High-resolution MR Combined with serum miR-140-3p and miR-223-3p detection can improve the diagnostic value of carotid atherosclerotic plaque vulnerability.
作者
丁超
刘永保
张春阳
张健煜
郭振委
Ding Chao;Liu Yongbao;Zhang Chunyang;Zhang Jianyu;Guo Zhenwei(Department of Medical Imaging,the First People's Hospital of Lianyungang,Jiangsu Province,Lianyungang 222061,China;不详)
出处
《疑难病杂志》
CAS
2024年第11期1336-1340,共5页
Chinese Journal of Difficult and Complicated Cases
基金
江苏省科技基础研究计划项目(BK20211214)。
