Flair高信号血管征联合炎症细胞预测急性脑梗死面积扩大的临床价值  

Clinical value of Flair hyperintense vessel sign combined with inflammatory cells in predicting the enlargement of acute cerebral infarction area

作　　者：宋鸿雁 段阳 杨本强 徐志华 张楠 裴禹淞 李晓秋 SONG Hong-yan;DUAN Yang;YANG Ben-qiang(Department of Radiology,Northern Theater Command General Hospital of Shenyang 110016,China)

机构地区：[1]中国人民解放军北部战区总医院放射科,沈阳110016 [2]中国人民解放军北部战区总医院神经内科,沈阳110016 [3]浙江省同德医院放射科

出　　处：《临床神经病学杂志》2021年第6期407-411,共5页Journal of Clinical Neurology

基　　金：辽宁省自然科学基金计划项目(201602768);沈阳市自然科学基金项目(202054044)。

摘　　要：目的探讨Flair高信号血管征(HVS)联合炎症细胞预测急性脑梗死面积扩大的应用价值。方法收集72例急性前循环闭塞性脑梗死患者的临床、实验室和影像资料。参考Alberta卒中项目早期CT评分(ASPECTS)评估HVS(HVS-ASPECTS)、对CT及DWI显示梗死面积行ASPECTS评分(CT-ASPECTS、DWI-ASPECTS)。根据CT-ASPECTS与DWI-ASPECTS的差值评估梗死面积是否扩大并分析其独立影响因素。用ROC曲线分析HVS-ASPECTS、中性粒细胞计数对梗死面积扩大的预测价值,并与出院时mRS评分进行相关性分析。结果HVS-ASPECTS、中性粒细胞计数与急性脑梗死面积扩大独立相关(均P<0.05)。HVS-ASPECTS、中性粒细胞计数单项及联合曲线下面积为0.789、0.717、0.830;联合时灵敏度、特异度为0.917、0.708,灵敏度较各单项检测明显提高。Spearman相关性分析显示,HVS-ASPECTS、中性粒细胞计数与出院时mRS评分的相关性分别为r=-0.414(P=0.000)、r=0.281(P=0.017)。结论HVS-ASPECTS、中性粒细胞计数可作为独立预测急性脑梗死面积扩大的标志,二者联合、相互补充可提高预测价值,并且这两项指标与近期功能转归有一定相关性。Objective To explore the application value of Flair hyperintense vessel sign(HVS)combined with inflammatory cells in predicting the enlargement of acute cerebral infarction area.Methods The clinical,laboratory indicators and imaging data of 72 cerebral infarction patients with acute anterior circulation occlusion were collected.Refer to the early CT score of Alberta Stroke Project to evaluate HVS(HVS-ASPECTS),and performed ASPECTS scores for CT and DWI(CT-ASPECTS,DWI-ASPECTS)showing the infarction area.The enlargement of infarction area was evaluated according to the difference between CT-ASPECTS and DWI-ASPECTS,then its independent influencing factors were analyzed.The predictive value of HVS-ASPECTS and neutrophil count for infarct enlargement was analyzed by ROC curve,and the Spearman correlation between HVS-ASPECTS,neutrophil count and mRS scores were analyzed.Results HVS-ASPECTS and neutrophil count were independently related to the enlargement of acute cerebral infarction area(allP<0.05).The area under the curve of HVS-ASPECTS,neutrophil count and their combination were 0.789,0.717,0.830,respectively.The sensitivity and specificity of the combination of the two indicators in predicting were 0.917,0.708,and the sensitivity was significantly higher than that of each single detection.Spearman correlation analysis showed that the correlation between HVS-ASPECTS,neutrophil count and mRS score at discharge were r=-0.414(P=0.000),r=0.281(P=0.017).Conclusions HVS-ASPECTS and neutrophil count are the independent predictors of acute cerebral infarction area enlargement.Their combination can complement each other and improve the predictive value of clinical,and the two indicators have a certain correlation with the recent functional outcome.

关 键 词：急性脑梗死 高信号血管征 中性粒细胞 

分 类 号：R743.3[医药卫生—神经病学与精神病学]