血清miRNA水平预测脑卒中取栓术后出血转化价值

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[关键词] 微RNAs;卒中;栓子清除术;出血;预后;列线图 [中图分类号] R743;R342.2 [文献标志码] A [文章编号] 2096-532（2025）02-0209-06

[Abstract] Objective ToexplorethepredictivevalueofserumexpresionlevelsofmicroRNAs（miR-137，miR-134，and miR-146b）forhemorhagictransformationaftermechanicalthrombectomyinpatientswithlargeveseloclusionstroke，andto constructandvalidateariskpredictionmodel. Methods Thedataof19patientswithlargeveseloclusionstrokeundergoing mechanicalthrombectomyatNanyangSecondPeople'sHospitalfrom March2020toMarch2021wereanalyzed.Thepatientswere dividedintonon-hemorhagicgroupandhemorhagicgroupacordingtopostoperativeimagingresults.TheindependentfactorsinfluencingpostoperativebledingtransformationweredeterminedthroughunivariableanalysesandamultivariableLogisticregressionanalysis，andsubsequently，anomogrampredictionmodelwasconstructedandasesed Results Thepostoperativehemorrhagerateofthemodelingsetwas 51.26% .Serum miR-137，miR-134，andmiR-146blevels，activatedpartialthromboplastintime （APTT），preoperativeNationalInstitutesofHealthStrokeScalescore，thepresenceofhypertension，andthenumberofthrombectomyatemptsweresignificantlyasociatedwithpostoperativehemorhagictransformation ， 11.436，P<0.05） ）.Thepresenceofhypertension，thenumberofthrombectomyatempts，andserum miR-134levelwereriskfactorsforpostoperativebleding OR=4.546-11.930，P<0.05） ），whileAPTT，miR-137，andmiR-146bwereprotectivefactors againstpostoperativebledinginthosepatients ⋅OR=0.086-0.992，P<0.05） ）.Fortheriskpredictionmodelinthemodelingset， theareaunderthereceiveroperatingcharacteristiccurve （AUC）was0.83，withasensitivityof 80.30% andaspecificityof 84.50% ;inthevalidationset，theAUCwas0.975，withasensitivityof 96.30% andaspecificityof 87.50% .Thecalibrationcurve andclinicaldecisioncurvebothshowedgodpredictiveperformance. Conclusion Theriskpredictionmodelincorporatinghypertension，miRNA，APTT，andthenumberofthrombectomyatemptsshowsexcelentclinicalpredictioneficacy，whichcanfacilitatetimelyhealthstatusasesmentandtreatmentplanformulationforpatientswithlargeveseloclusionstroketoreducetherisk ofpostoperativehemorhagictransformation.

[Keywords] microRNAs;stroke;embolectomy;hemorhage;prognosis;nomograms

大血管闭塞性脑卒中是一种缺血性脑卒中，由大血管闭塞引起，导致脑部血氧供应中断，需要紧急进行溶栓治疗或者机械取栓术等治疗[1]。（剩余6593字）