磁共振弥散加权成像参数联合miR-21-5p对急性脑干梗死患者预后不良的预测价值

Predictive value of magnetic resonance diffusion weighted imaging combined with miR 21-5p for poor prognosis of patients with acute brainstem infarction

目的探讨磁共振弥散加权成像(DWI)参数联合微小RNA-21-5p(miR-21-5p)对急性脑干梗死患者预后不良的预测价值。方法回顾性选取2021年6月至2023年6月丽水市中心医院收治的88例急性脑干梗死患者,患者入院后接受常规对症治疗与DWI检查。治疗后对患者随访3个月,根据改良Rankin量表(mRS)评估患者预后,比较不同预后情况患者的梗死区DWI参数[表观弥散系数(ADC)、DWI异常高信号面积(S_(DWI))]和血清miR-21-5p表达;采用多因素logistic回归分析急性脑干梗死患者预后不良的独立危险因素;绘制ROC曲线分析ADC、S_(DWI)、miR-21-5p对急性脑干梗死患者预后不良的预测效能。结果预后不良组的ADC低于预后良好组,S_(DWI)、miR-21-5p表达高于预后良好组(均P<0.05);多因素logistic回归分析显示,有高血压病(OR=2.081)、ADC降低(OR=1.948)、S_(DWI)升高(OR=1.960)及miR-21-5p升高(OR=2.136)均是急性脑干梗死患者预后不良的独立危险因素(均P<0.05)。ROC曲线分析显示,ADC、S_(DWI)、miR-21-5p单一及联合检测的AUC分别为0.807、0.817、0.815、0.930,联合检测的AUC优于单一检测。结论DWI参数联合miR-21-5p预测急性脑干梗死患者预后情况具有一定价值。

Objective To analyze the predictive value of magnetic resonance diffusion weighted imaging(DWI)parameters combined with microRNA-21-5p(miR-21-5p)for poor prognosis in patients with acute brain stem infarction.Methods A total of 88 patients with acute brainstem infarction admitted to Lishui Central Hospital from June 2021 to June 2023 were retrospectively selected.The patients received routine symptomatic treatment and DWI examination while admission.They were followed up for 3 months after treatment,and their prognosis was evaluated according to the modified Rankin Scale(mRS).The parameters of DWI in infarction area[apparent diffusion coefficient(ADC),square measure of DWI(S_(DWI))]and serum miR-21-5p expression of patients with different prognosis were compared.Multivariate logistic regression was used to analyze the independent risk factors for poor prognosis of patients with acute brainstem infarction.ROC curve was drawn to analyze the predictive value of ADC,S_(DWI)and miR-21-5p for poor prognosis of patients with acute brainstem infarction.Results The ADC of the poor prognosis group was lower than that of the good prognosis group,and the expressions of S_(DWI)and miR-21-5p were higher than those of the good prognosis group(all P<0.05).Multivariate logistic regression analysis showed that high blood pressure(OR=2.081),decreased ADC(OR=1.948),increased S_(DWI)(OR=1.960)and increased miR-21-5p(OR=2.136)were independent risk factors for poor prognosis of patients with acute brain stem infarction(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of ADC,S_(DWI),miR-21-5p and combined detection were 0.807,0.817,0.815 and 0.930,respectively,and the AUC of combined detection was superior to that of any single detection.Conclusion DWI parameters combined with miR-21-5p have a certain value in predicting the prognosis of patients with acute brain stem infarction.