| 摘要: |
| 目的? 探究能谱CT单能量成像联合微小RNA(miR)-146a预测血管外科术后患者下肢深静脉血栓形成(DVT)的价值。方法? 选取2022年1月～2024年11月南京大学医学院附属苏州医院(苏州科技城医院)258例血管外科术后患者,根据术后3个月下肢DVT发生情况分为DVT组(n=50)和N-DVT组(n=208)。比较两组一般资料、能谱CT单能量成像参数及血清miR-146a水平,采用LASSO筛选变量,Logistic回归方程分析下肢DVT发生影响因素,绘制受试者工作特征曲线(ROC)及曲线下面积(AUC)分析CT单能量成像参数及血清miR-146a预测下肢DVT发生价值。结果? DVT组凝血酶时间(TT)、D-二聚体(D-D)、纤维蛋白原(Fib)水平均高于N-DVT组(P＜0.05)；DVT组40～70 KeV时下腔静脉、股静脉、腘静脉CT值高于N-DVT组,血清miR-146a水平低于N-DVT组(P＜0.05)；LASSO回归算法筛选获取变量为40～70 KeV时下腔静脉、股静脉、腘静脉CT值及miR-146a；Logistic回归方程分析显示,40～70 KeV时下腔静脉、股静脉、腘静脉CT值及miR-146a均是患者下肢DVT发生的影响因素(P＜0.05)；40～70 KeV时下腔静脉、股静脉、腘静脉CT值、miR-146a联合预测下肢DVT的AUC为0.897,明显高于各指标单独预测价值(P＜0.05)。结论? 能谱CT单能量成像联合miR-146a与血管外科术后患者下肢DVT存在一定关联,且40～70 KeV时下腔静脉、股静脉、腘静脉CT值、miR-146a联合对患者术后DVT预测具有良好的价值。 |
| 关键词: 能谱CT单能量成像 miR-146a 血管外科术 下肢 深静脉血栓形成 |
| DOI： |
| 分类号: |
| 基金项目:江苏省优势学科建设工程项目：YSHL2201-274；苏州市医学会：2025YX-M04 |
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| Value of spectral CT single-energy imaging combined with miR-146a in predicting the formation of deep venous thrombosis in the lower extremities of patients after vascular surgery |
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dingxiang
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Suzhou Hospital Affiliated to Nanjing University School of Medicine (Suzhou Science and Technology City Hospital)
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| Abstract: |
| Objective ?To explore the value of spectral CT single-energy imaging combined with microRNA (miR)-146a in predicting deep vein thrombosis (DVT) in the lower extremities of patients after vascular surgery. Methods ?A total of 258 patients who underwent vascular surgery in Suzhou Hospital Affiliated to Nanjing University Medical School (Suzhou Science and Technology City Hospital) from January 2022 to November 2024 were selected. They were divided into the DVT group (n=50) and the N-DVT group (n=208) based on the occurrence of DVT in the lower extremities three months after surgery. The general information, spectral CT single-energy imaging parameters, and serum miR-146a levels of the two groups were compared. LASSO was used to screen variables, and logistic regression equations were used to analyze the influencing factors of DVT occurrence in the lower extremities. Receiver Operating Characteristic (ROC) curves and Area Under the Curve (AUC) were plotted to analyze the predictive value of CT single-energy imaging parameters and serum miR-146a levels for DVT occurrence in the lower extremities. Results The levels of thrombin time (TT), D-dimer (D-D), and fibrinogen (Fib) in the DVT group were higher than those in the N-DVT group (P<0.05). The CT values of the inferior vena cava, femoral vein, and popliteal vein at 40-70 KeV in the DVT group were higher than those in the N-DVT group, while the serum miR-146a level was lower (P<0.05). The LASSO regression algorithm identified the following variables as influencing factors for the occurrence of DVT in the lower extremities: CT values of the inferior vena cava, femoral vein, and popliteal vein at 40-70 KeV, and miR-146a. Logistic regression analysis showed that these variables were all significant predictors of DVT in the lower extremities (P<0.05). The AUC of the combined prediction model, which includes CT values of the inferior vena cava, femoral vein, and popliteal vein at 40-70 KeV and miR-146a, was 0.897, significantly higher than that of each individual indicator alone (P<0.05). Conclusion Spectral CT single-energy imaging combined with miR-146a shows a certain correlation with the presence of DVT in the lower extremities of patients after vascular surgery. Furthermore, the combination of CT values and miR-146a at 40-70 KeV in the inferior vena cava, femoral vein, and popliteal vein has good predictive value for postoperative DVT in patients. |
| Key words: Spectral CT single-energy imaging miR-146a Vascular surgery Lower extremities Deep venous thrombosis |
