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Objective:To investigate the prognostic value of serum levels of miR-134 and miR-146b in elderly patients with acute ischemic stroke(AIS).Methods:A total of 162 elderly patients with AIS admitted to the Third People's Hospital of Haikou from January 2017 to October 2019 were enrolled.According to modified Rankin Scale(mRS)scores, they were divided into the good prognosis group(n=98, mRS score≤2)and the poor prognosis group(n=64, mRS score>2). Based on the National Institutes of Health Stroke Scale(NIHSS), patients were divide into the mild group(n=46, NIHSS score<5), moderate group(n=75, 5≤NIHSS score≤20), and severe group(n=41, NIHSS score>20). Real-time fluorescence quantitative PCR was used to detect serum levels of miR-134 and miR-146b in each group.Multivariate logistic regression was used to analyze risk factors for poor prognosis in elderly patients with AIS.The receiver operating characteristic(ROC)curve was used to analyze the value of serum miR-134 and miR-146b levels in predicting poor prognosis of elderly patients with AIS.Pearson correlation was used to analyze the correlations of serum levels of miR-134 and miR-146b with NIHSS and mRS scores in elderly patients with AIS.Results:Serum levels of miR-134(3.26±1.13 vs.0.85±0.38)and miR-146b(2.27±0.93 vs.0.56±0.21)were higher in the AIS group than in the control group( t=14.360 and 12.527, P<0.01). Serum levels of miR-134(4.35±1.46 vs.2.28±0.85)and miR-146b(3.07±1.04 vs.1.51±0.66)were higher in the poor prognosis group than in the good prognosis group( t=13.520 and 11.242, P<0.01). Serum levels of miR-134 and miR-146b in the severe group were higher than in the moderate and mild groups( t=10.815 and 9.462, P<0.01), and they were also higher in the moderate group than in the mild group( t=13.627, 11.611, P<0.01). Multivariate Logistic regression analysis showed that serum miR-134( OR=2.470, 95% CI: 1.603-4.927)and miR-146b( OR=1.914, 95% CI: 1.350-3.406)were risk factors for poor prognosis in elderly AIS patients( P<0.05). The ROC curve analysis showed that the optimal cut-off values of serum miR-134 and miR-146b to predict poor prognosis in elderly AIS patients were 3.84 and 2.68, respectively.The area under the ROC curve(AUC)of combined serum miR-134 and miR-146b(0.926, 95% CI: 0.865-0.987)for the prediction of poor prognosis was higher than that of either marker alone, with a sensitivity and specificity of 92.4% and 86.2%, respectively.The correlation analysis showed that serum levels of miR-134 and miR-146b were positively correlated with NIHSS and mRS scores in elderly AIS patients( r=0.806, 0.871, 0.785 and 0.842, all P<0.01). Conclusions:Increased serum miR-134 and miR-146b levels are correlated with the severity of neurological impairment and prognosis in elderly patients with AIS.Serum miR-134 and miR-146b levels together have a high value in predicting poor prognosis in elderly AIS patients.
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Objective To analyze the correlation between clinical features and renal dysfunction in patients of acute lacunar infarction with progressive cerebral microbleeds (CMBs). Methods Two hundred and sixty-five patients with first-episode acute lacunar infarction were selected. The serum creatinine was measured within 24 h of admission and the estimated glomerular filtration rate (eGFR) was calculated. The brain MRI (including gradient-echo images) was examined within 2 d of admission and after 1 years of follow-up, respectively. The progressive CMBs was assessed with microbleeds anatomical rating scale (MARS), and the patients were divided into progressive CMBs group (progressive group, 42 cases) and non progressive CMBs group (non progressive group, 223 cases). The clinical features of 2 groups were compared and the correlation between progressive CMBs and renal dysfunction was analyzed. Results The age, 24 h pulse pressure, incidences of renal dysfunction and CMBs in progressive group were significantly higher than those in non progressive group: (69.8 ± 5.8) years vs. (61.5 ± 4.9) years, (63.3 ± 3.1) mmHg (1 mmHg=0.133 kPa) vs. (51.8 ± 4.2) mmHg, 69.0％(29/42) vs. 39.9％(89/223) and 57.1％(24/42) vs. 25.1％(56/223), and the platelet was significantly lower than that in non-progression group:(168 ± 35) ×109/L vs. (189 ± 40) ×109/L, and there were statistical differences (P<0.05 or<0.01). The Logistic regression analysis result showed that renal dysfunction and CMBs were Independent risk factors of progressive CMBs (OR = 1.571 and 1.054, 95％ CI 1.042 - 2.493 and 1.010 - 1.142, P<0.05). Conclusions The rate of renal dysfunction is higher in patients of acute lacunar infarction with progressive CMBs, and progressive CMBs are associated with renal dysfunction.
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Objective To investigate the relationship between different topographic locations and neurological deteriorations (ND) in patients with acute new isolated pontine infarction.Methods One hundred sixty-eight patients with acute new isolated pontine infarction during arch 2012 to March 2016 were identified by diffusion weighted imaging (DWI) for retrospective review.Patients were divided into two groups according to their clinical symptoms:patients with ND and patients without ND.According to neuroimaging of DWI,the topographic location of pontine infarction was divided into three types:The upper,middle,and lower ones,and the correlations of ND with risk factors,laboratory examination results,clinical manifestations and different topographic locations were explored by statistical tests.Results Of 168 patients,26.8％ (45/168) were diagnosed with ND,and 73.2％ (123/168) were diagnosed without ND.Univariate analysis showed that there were differences in female ratio [62.2％ (28/45) vs 41.5％ (51/ 123)],smoking ratio [13.3％ (6/45) vs 26.0％ (32/123)],mean length of hospital stay [(22.83 ± 7.12)d vs (19.31 ± 7.65)d],ratio of worse short-term clinical outcomes [77.8％ (35/45) vs 33.3％ (41/123)],and ratio of lower pontine infarction [55.6％ (25/45) vs 26.0％ (32/123)] between two groups (P ＜ 0.05).Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND (OR =1.953,95％ CI:1.092-3.535,P =0.029).Conclusions Topographic location of lower pons lesions may be reliable predictor of ND in acute new isolated pontine infarction.