FVH-DWI不匹配联合血清IL-6、miR-155对进展性脑梗死的预测价值

The predictive value of FVH-DWI mismatch combined with serum IL-6 and miR-155 in patients with progressive cerebral infarction

目的探讨液体衰减反转恢复(FLAIR)序列血管高信号(FVH)-扩散加权成像(DWI)不匹配联合血清白细胞介素(IL)-6、miR-155对进展性脑梗死(PCI)的预测价值。方法选取105例已确诊的脑梗死患者,将其中35例作为PCI组,70例未发生PCI(NPCI)作为NPCI组,均于入院第1天采用酶联免疫吸附法、实时荧光定量聚合酶链反应测定血清IL-6、miR-155表达水平,并行MRI检查,统计FVH-DWI不匹配情况。绘制受试者工作特征(ROC)曲线分析上述指标对PCI的预测价值。结果PCI组FVH-DWI不匹配比例显著小于NPCI组(25.71%vs 58.57%),差异有统计学意义(P<0.05)。PCI组入院第1天血清IL-6水平(121.77±30.34)ng/L、miR-155表达水平(2.07±0.56)均显著高于NPCI组的(81.27±15.09)ng/L、(1.51±0.56),差异有统计学意义(P<0.05)。FVH-DWI不匹配与NIHSS评分呈负相关(P<0.05),血清IL-6、miR-155表达水平与NIHSS评分均呈正相关(P<0.05)。FVH-DWI不匹配联合血清IL-6、miR-155预测PCI的曲线下面积(AUC)为0.919,敏感度、特异度分别为74.29%、97.14%。结论FVH-DWI不匹配联合血清IL-6、miR-155检测对PCI有较高的预测价值。

Objective To explore the predictive value of fluid attenuated inversion recovery(FLAIR)sequence vascular high signal(FVH)-diffusion-weighted imaging(DWI)mismatch combined with serum interleukin(IL)-6 and micRNA-155(miR-155)in progressive cerebral infarction(PCI).Methods A total of 105 patients with cerebral infarction admitted to our hospital were selected as the study objects,among whom 35 patients had PCI(PCI group)and 70 patients had non-PCI(NPCI group).The expression levels of serum IL-6 and miR-155 were measured by enzyme-linked immunosorbent assay and real-time fluorescence quantitative polymerase chain reaction in all patients on the 1st day after admission,and relevant MRI examinations were performed to evaluate the mismatch of FVH-DWI.The predictive value of these indicators to PCI was analyzed by receiver operating characteristic(ROC)curve.Results The proportion of FVH-DWI mismatch in PCI group was significantly lower than that in NPCI group(25.71%vs 58.57%)(P<0.05).Serum IL-6 level[(121.77±30.34)vs(81.27±15.09)ng/L]and miR-155 expression level[(2.07±0.56)vs(1.51±0.56)]in PCI group were significantly higher than those in NPCI group(P<0.05).FVH-DWI mismatch was negatively correlated with NIHSS score(P<0.05),and serum IL-6 and miR-155 expression levels were positively correlated with NIHSS score(P<0.05).The area under the curve of FVH-DWI mismatch combined with serum IL-6 and miR-155 in the prediction of PCI was 0.919,and the sensitivity and specificity were 74.29%and 97.14%.Conclusions FVH-DWI mismatch combined with serum IL-6 and miR-155 detection has high predictive value for PCI.