CT灌注成像参数联合血清miR-217-5p对缺血性脑卒中的诊断价值

Diagnostic value of CT perfusion imaging parameters combined with serum miR⁃217⁃5p inischemic stroke

目的 分析研究CT灌注成像参数联合血清miR-217-5p水平对缺血性脑卒中患者的诊断价值。方法 选取2020年1月至2022年12月辽宁省健康产业集团阜新矿总医院收治的124例疑似缺血性脑卒中患者作为研究对象,根据检查结果,将确诊为缺血性脑卒中的患者分为缺血性卒中组(n=68),非缺血性脑卒中的患者分为对照组(n=56)。对两组患者进行CT灌注成像检查,比较两组的脑血流量(CBF)、脑血容量(CBV)平均通过时间(MTT)、到达峰值时间(TTP);比较两组血清miR-217-5p表达水平;采用多因素Logistic回归分析发生缺血性脑卒中的影响因素,并采用ROC曲线分析CT灌注成像参数(CBF、CBV、MTT、TTP)联合血清miR-217-5p表达水平对诊断缺血性脑卒中的预测价值。结果 年龄、高血压病史、CBF、CBV、MTT、TTP与血清miR-217-5p表达水平均是发生缺血性脑卒中的影响因素,差异均具有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄>60岁(OR=2.102)、有高血压病史(OR=1.793)、CBF水平降低(OR=1.891)、CBV水平降低(OR=1.914)、MTT水平升高(OR=2.121)、TTP水平升高(OR=1.889)和miR-217-5p表达水平降低(OR=2.090)均是发生缺血性脑卒中的独立危险因素(P<0.05)。ROC曲线分析显示CBF、CBV、MTT、TTP、血清miR-217-5p表达水平及联合检测的曲线下面积(AUC)分别为0.899、0.947、0.909、0.916、0.822、0.999,联合检测优于单一检测(P<0.05)。结论 CT灌注成像参数与血清miR-217-5p表达水平对缺血性脑卒中具有一定的诊断价值,联合检测的诊断价值优于单一检测。

Objective To analyze the diagnostic value of CT perfusion imaging parameters combined with serum miR-217-5p level in patients with ischemic stroke.Methods A total of 124 suspected ischemic stroke patients admitted to Fuxinmine General Hospital of Liaoning Health Industry Group from January 2020 to December 2022 were selected as the research objects.According to the examination results,the patients diagnosed with ischemic stroke were divided into the ischemic stroke group(n=68)and the non-ischemic stroke patients into the control group(n=56).CT perfusion imaging was performed to compare the cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT)and peak time(TTP)of the two groups.The expression levels of serum miR-217-5p were compared between the two groups.Multivariate Logistic regression was used to analyze the influencing factors of ischemic stroke,and the ROC curve was used to analyze the predictive value of CT perfusion imaging parameters(CBF,CBV,MTT,TTP)combined with serum miR-217-5p expression levels in the diagnosis of ischemic stroke.Results Age,hypertensive history,CBF,CBV,MTT,TTP and serum miR-217-5p expression levels were all influential factors in the occurrence of ischemic stroke,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that Age>60 years old(OR=2.102),history of hypertension(OR=1.793),decreased CBF level(OR=1.891),decreased CBV level(OR=1.914),increased MTT level(OR=2.121),increased TTP level(OR=1.889),and miR-217-5p expression level Reduction(OR=2.090)was an independent risk factor for ischemic stroke(P<0.05).The ROC curve analysis showed that the expression levels of CBF,CBV,MTT,TTP and serum miR-217-5p and the area under the curve(AUC)of combined detection were 0.899,0.947,0.909,0.916,0.822 and 0.999,respectively.Combined detection was superior to single detection(P<0.05).Conclusion CT perfusion imaging parameters and serum miR-217-5p expression level have certain diagnostic value in ischemic stroke,and the combined detection is better than single detection.