磁共振DKI参数联合血清miR-146a评估AD患者研究

Study on magnetic resonance imaging DKI parameters and serum miR-146a in the evaluation of the disease condition of patients with Alzheimer’s disease

目的 分析磁共振弥散峰度成像(DKI)参数联合血清微小核糖核酸-146a (miR-146a)评估阿尔茨海默病(AD)患者病情的风险价值。方法选取儋州市人民医院2018年4月-2020年6月收治的123例AD患者,所有患者均接受2个月常规治疗,治疗前磁共振DKI、血清miR-146a检查。治疗结束评估患者病情进展情况并分组;采集并比较患者相关基线资料,重点分析磁共振DKI参数[平均弥散峰度(MK)、径向峰度(RK)、轴向峰度(AK)]联合血清miR-146a评估AD患者病情进展风险价值。结果123例AD患者经2个月治疗有34例患者病情进展,进展率为27.64%;较未进展组,进展组MK、RK、AK较低(P<0.05);较未进展组,进展组β淀粉样蛋白1-42 (Aβ1-42)水平较低,miR-146a水平较高(P <0.05);对比两组性别、年龄、病程、受教育程度、合并基础疾病,差异无统计学意义(P> 0.05);经Logistic回归分析结果显示,Aβ1-42升高可能是AD患者病情进展的保护因子(OR<1,P <0.05),miR-146a升高可能是AD患者病情进展的风险因子(OR>1,P<0.05);绘制ROC曲线发现,磁共振DKI参数(MK、RK、AK)、miR-146a单独及联合检测评估AD患者病情进展风险的AUC均>0.80,均有一定预测价值,且联合检测评估价值更高。结论磁共振DKI参数联合血清miR-146a评估AD患者病情风险有一定应用价值。

Objective To analyze the value of magnetic resonance imaging diffusional kurtosis imaging(DKI)parameters combined with serum microRNA-146 a(miR-146 a) in evaluating the risk value of disease condition of patients with Alzheimer’s disease(AD).Methods 123 patients with AD admitted to Danzhou People’s Hospital from April 2018 to June 2020 were selected.All patients received routine treatment for 2 months,before treatment,patients were examined with magnetic resonance imaging DKI and serum miR-146 a,at the end of treatment,the disease progression of patients was evaluated and divided them into groups;the related baseline data of patients were collected and compared,the value of magnetic resonance imaging DKI parameters [mean diffuse kurtosis(MK),radial kurtosis(RK),axial kurtosis(AK)] combined with serum miR-146 a in evaluating the risk of disease progression of patients with AD was mainly analyzed.Results After 2 months of treatment,34 of 123 AD patients had progression,and the progression rate was 27.64%;compared with the non progressive group,MK,RK and AK in the progressive group were lower(P<0.05);compared with the non progressive group,β Amyloid 1-42(A β 1-42) level in the progression group was lower,miR-146 a level was higher(P<0.05);there was no statistical significant difference in gender,age,course of disease,education and basic diseases between the two groups(P>0.05);the results of Logistic regression analysis showed that increased A β 1-42 might be a protective factor for the disease progression of patients with AD(0 R<1,P<0.05),increased miR-146 a might be a risk factor for the disease progression of patients with AD(OR>1,P<0.05);ROC curve was drawn and showed that the AUC of magnetic resonance imaging DKI parameters(MK,RK,AK) and miR-146 a alone or combined detection to assess the risk of disease progression of patients with AD were>0.80,all of them had certain predictive value,and the joint detection evaluation value was higher.Conclusion Magnetic resonance imaging DKI parameters combined with serum miR-146 a have certain application value in evaluating the risk value of disease condition of patients with AD.