磁共振弥散张量成像技术联合血清乙酰肝素酶对于高血压脑出血患者的预后评估  

Prognosis assessment of patients with hypertensive cerebral hemorrhage by magnetic resonance diffusion tensor imaging combined with serum heparitinase

作　　者：周俊梅 白永杰[1] Zhou Junmei;Bai Yongjie

机构地区：[1]郑州市第二人民医院,450000

出　　处：《中国疗养医学》2020年第10期1021-1024,共4页Chinese Journal of Convalescent Medicine

基　　金：河南省医学科技攻关项目(201702306)。

摘　　要：目的探究运用磁共振弥散张量成像(diffusion tensor imaging,DTI)技术联合血清乙酰肝素酶(heparitinase,HPA)的测定评估高血压脑出血(hypertensive cerebral hemorrhage,HICH)患者预后的价值。方法纳入某院2018年2月至2019年9月就诊的HICH患者48例,按照预后结果分为对照组和预后不佳组,所有患者均进行DTI检查、血清HPA测定、皮质脊髓束(cortical spinal tract,CST)损伤分级和Brunnstrom评分。对血肿处CST的部分各向异性分数(FA)进行测量和统计,计算其相对值(rFA)。以上各项指标的检查时间为患者入院7 d内、接受康复治疗1个月后和接受治疗3个月后。结果入院时,预后不佳组的rFA值、血清HPA含量和Brunnstrom评级较低,CST分级较高(P<0.05);1个月后,两组患者肌力均得到改善,rFA值和血清HPA水平较入院时升高(P<0.05),且对照组HPA浓度高于预后不佳组(P<0.05);3个月后,对照组Brunnstrom评级、rFA值高于预后不佳组(P<0.05),预后不佳组患者的CST级别较高(P<0.05),两组患者的血清HPA含量差异无统计学意义(P>0.05)。入院时和发病1个月后的rFA值与血清HPA含量同Brunnstrom评分呈正相关(=0.792,0.803,P<0.05)。结论DTI技术可准确测量HICH患者rFA值,评估患者CST受损程度,联合血清HPA检测可早期预测患者预后。Objective To explore the methods of magnetic resonance diffusion tensor imaging(DTI)combined with serum heparitinase(HPA)to evaluate the prognosis of hypertensive cerebral hemorrhage(HICH)patients.Me thods Forty-eight patients with HICH who visited a hospital from February 2018 to September 2019 were included. According to the prognosis,they were divided into control group and poor prognosis group. All patients underwent DTI examination,serum HPA measurement,cortical spinal tract(CST)injury classification and Brunnstrom score.The fraction anisotropy(FA)of CST in hematoma was measured and counted,and the relative fraction anisotropy value(rFA)was calculated. The above indicators were examined within 7 days after admission,1 month after rehabilitation treatment and 3 months after treatment.Re s ults On admission,the r FA,serum HPA and Brunnstrom ratings in the group with poor prognosis were lower and the CST rating was higher(P<0.05).After 1 month,muscle strength was improved in both groups,r FA value and serum HPA level were increased compared with those at admission( P <0.05),and HPA concentration in the control group was higher than that in the group with poor prognosis( P <0.05).After 3 months,Brunnstrom rating and r FA value were higher in the control group than in the poor prognosis group(P <0.05),and patients in the poor prognosis group had a higher CST level(P<0.05),and there was no statistically significant difference in serum HPA content between the two groups(P >0.05).RFA value at admission and 1 month after onset was positively correlated with serum HPA content and Brunnstrom score(r =0.792,0.803,P <0.05). Conclus ion DTI technology can accurately measure the r FA value of HICH patients,assess the degree of CST damage in patients,and combine with serum HPA detection to predict the prognosis of patients early.

关 键 词：弥散张量成像 脑出血 高血压 乙酰肝素酶 预后 评估 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]