多时相CT血管造影检查、血清LPO、TpP水平与老年人急性脑梗死再发的相关性研究  

Correlation between multiphase CT angiography, serum lipid peroxidation and thrombus precursor protein levels and recurrence of acute cerebral infarction in older adults

作　　者：毛思涵 霍红丹 陈秋露 樊如梦 Mao Sihan;Huo Hongdan;Chen Qiulu;Fan Rumeng(Department of Neurology,Zhejiang Medical and Health Group Hangzhou Hospital,Hangzhou 310000,Zhejiang Province,China;Department of Geriatrics,Yuyao Third People's Hospital,Yuyao 315402,Zhejiang Province,China;Department of Neurology,Ningbo Medical Center Lihuili Hospital,Ningbo 315046,Zhejiang Province,China)

机构地区：[1]浙江省医疗健康集团杭州医院神经内科,杭州310000 [2]余姚市第三人民医院老年科,余姚315402 [3]宁波市医疗中心李惠利医院神经内科,宁波315046

出　　处：《中国基层医药》2022年第5期747-752,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨多时相CT血管造影(mCTA)检查、血清脂质过氧化物(LPO)、血栓前体蛋白(TpP)水平与老年人急性脑梗死再发的相关性及预测价值。方法收集浙江省医疗健康集团杭州医院2019年1月至2020年1月收治的老年急性脑梗死患者128例,对患者随访1年,根据患者是否再发脑梗死将患者分为再发脑梗死组29例,未再发脑梗死组99例,所有患者行mCTA检查,根据mCTA图像进行Maas评分和Tan评分,采用酶联免疫吸附测定(ELISA)测定两组患者的血清TpP水平,采用Yagi微量荧光法测定两组患者的血清LPO含量,相关性分析采用多元线性回归分析,诊断效果评价采用受试者工作特征曲线(ROC)。结果再发脑梗死组Tan评分为(1.06±0.26)分,显著低于未再发脑梗死组的(1.89±0.82)分(t=5.35,P<0.05);再发脑梗死组TpP、LPO水平分别为(7.22±1.35)mmol/L、(11.23±2.58)nmol/mL,均高于未再发脑梗死组的(3.06±0.28)mmol/L、(7.23±0.37)nmol/mL(t=28.86、15.04,均P<0.001);老年急性脑梗死患者再发与Tan评分、LPO、TpP水平均存在相关性(P<0.05);mCTA、LPO、TpP水平诊断老年急性脑梗死患者再发的敏感度在93.10%~96.60%之间,特异度均为100.00%;受试者工作特征曲线(ROC)分析显示,mCTA、LPO、TpP诊断老年急性脑梗死患者再发的ROC曲线下面积分别为0.986(95%CI为0.966~1.000)、0.976(95%CI为0.930~1.000)、0.968(95%CI为0.905~1.000)。结论老年人急性脑梗死再发与多时相CT血管造影Tan评分、LPO、TpP水平均存在相关性,多时相CT血管造影Tan评分、LPO、TpP水平诊断老年急性脑梗死患者再发敏感度和特异度均较高,有较高的诊断价值。Objective To correlate multiphase CT angiography(mCTA),serum lipid peroxidation(LPO)and thrombus precursor protein(TpP)levels with recurrence of acute cerebral infarction(ACI)in older adults and investigate the value of these indicators in the predication of ACI recurrence.Methods A total of 128 older adult patients with ACI who received treatment in Ningbo Medical Center Lihuili Hospital,China between January 2019 and January 2020 were included in this study.All of them were followed up for 1 year.They were divided into ACI recurrence group(n=29)and no ACI recurrence group(n=99)according to whether they had recurrent cerebral infarction.All patients underwent mCTA.Maas system and Tan score were used according to mCTA images.Serum TpP level was measured using enzyme-linked immunosorbent assay.Serum LPO level was measured using Yagi's fluorescence method.Multiple linear regression analysis was used for correlation analysis.The receiver operating characteristic(ROC)curve was used to evaluate the efficacy of mCTA and serum LPO and TpP levels in the diagnosis of ACI.Results Tan score in the ACI recurrence group was significantly lower than that in the no ACI recurrence group[(1.06±0.26)points vs.(1.89±0.82)points,t=5.35,P<0.05].Serum TpP and LPO levels in the ACI recurrence group were(7.22±1.35)mmol/L and(11.23±2.58)nmol/mL,respectively,which were significantly higher than those in the no ACI recurrence group[(3.06±0.28)mmol/L,(7.23±0.37)nmol/mL,t=28.86,15.04,both P<0.001].ACI recurrence in older adult patients was correlated with Tan score and serum LPO and TpP levels(both P<0.05).The sensitivity of mCTA combined with serum LPO and TpP levels in the diagnosis of ACI in older adults was 93.10%-96.60%and its specificity was 100.00%.The ROC curve analysis showed that the area under the ROC of mCTA,LPO and TpP in the prediction of ACI recurrence in older adults was 0.986(95%CI=0.966-1.000),0.976(95%CI=0.930-1.000)and 0.968(95%CI=0.905-1.000),respectively.Conclusion ACI recurrence in older adults is correlated with

关 键 词：脑血管造影术 体层摄影术 X线计算机 脑梗死 脂质过氧化物 血栓前体蛋白 敏感性 特异性 再发 血栓 预测 

分 类 号：R743.33[医药卫生—神经病学与精神病学]