急性脑梗死早期血清EphA2蛋白、静息态Bold-fMRI、DTI参数动态变化在肢体运动功能恢复中的预测价值  

Value of Dynamic Changes of Serum EphA2 Protein,Resting State Bold-fMRI and DTI Parameters in the Relationship with Muscle Strength and Predicting the Recovery of Limb Motor Function in the Early Stage of Acute Cerebral Infarction

作　　者：陈历 季一飞 蒋炳虎 靳雨 尹书斌 Chen Li;Ji Yifei;Jiang Binghu;Jin Yu;Yin Shubin(Department of Neurology,Nanchong Central Hospital,Nanchong 637000,Sichuan Province,China;不详)

机构地区：[1]南充市中心医院神经内科,四川省南充市637000 [2]南充市中心医院医学影像科,四川省南充市637000

出　　处：《中国病案》2022年第4期98-102,共5页Chinese Medical Record

基　　金：四川省南充市市校科技战略合作项目应用基础课题研究(19SXHZ0264)。

摘　　要：目的 探讨急性脑梗死早期血清Eph受体酪氨酸激酶A2蛋白、静息态血氧水平依赖-功能磁共振成像、磁共振弥散张量成像参数动态变化预测肢体运动功能恢复的价值。方法 选取2020年1月1日~2020年8月30日某院100例急性脑梗死患者,分为良好组(n=72)、不良组(n=28),比较两组血清EphA2蛋白、患侧颅内初级感觉运动区(SMC)、辅助运动区(SMA)、运动前区(PM)、后顶叶皮层(PPC)低频振幅(ALFF)、患侧各向异性参数(FA)、肌力,分析各指标与肌力的关系,以及血清EphA2蛋白、静息态Bold-fMRl、DTI参数预测肢体功能恢复不良的价值。结果 良好组发病3天EphA2蛋白[(50.01±10.37)pg/ml]、7天EphA2蛋白[(36.78±9.91)pg/ml]低于不良组的[(55.99±12.44)pg/ml、(54.17±11.24)pg/ml](P<0.05);良好组发病3天、7天SMC-ALFF[(0.89±0.13)、(0.93±0.12)]、SMA-ALFF[(0.84±0.14)、(0.96±0.10)]、PM-ALFF[(0.81±0.10)、(0.94±0.11)]、PPC-ALFF[(0.83±0.13)、(1.01±0.14)]、FA[(0.42±0.05)、(0.51±0.08)]高于不良组的[(0.81±0.17)、(0.82±0.14)]、[(0.74±0.15)、(0.75±0.13)]、[(0.71±0.15)、(0.73±0.12)]、[(0.74±0.15)、(0.75±0.16)]、[(0.36±0.07)、(0.36±0.06)](P<0.05);良好组与不良组肌力等级分布比较,差异有统计学意义(P<0.05);发病3天、7天血清EphA2蛋白与肌力呈负相关,SMC-ALFF、SMA-ALFF、PM-ALFF、PPC-ALFF、FA与肌力呈正相关(P<0.05);发病7天各指标预测肢体功能恢复不良的AUC大于对应指标发病3天时,AUC均>0.07。结论 急性脑梗死早期血清EphA2蛋白、静息态Bold-fMRI、DTI参数呈动态变化,与肌力具有相关性,可作为预测肢体运动功能恢复情况有力依据。Objective To investigate the value of dynamic changes of serum Eph receptor tyrosine kinase A2 protein,resting blood oxygen level dependent functional magnetic resonance imaging(fMRI) and diffusion tensor imaging(DTI)parameters in predicting the recovery of limb motor function in the early stage of acute cerebral infarction.Methods 100patients with acute cerebral infarction in our hospital were divided into good group(n = 72) and bad group(n = 28).The serum Eph A2 protein,primary sensorimotor area(SMC),auxiliary motor area(SMA),premotor area(PM),low frequency amplitude(Alff) of posterior parietal cortex(PPC),anisotropy parameter(FA) and muscle strength of the two groups were compared,The relationship between each index and muscle strength was analyzed,and the value of serum Eph A2 protein,resting bold fmrl and DTI parameters in predicting poor recovery of limb function was analyzed.Results The onset of 3 days EphA2 protein [(50.01±10.37)pg/ml] and 7 days EphA2 protein [(36.78±9.91)pg/ml] in the good group were lower than those in the bad group [(55.99±12.44)pg/ml,(54.17± 11.24) pg/ml](P<0.07).Conclusion The dynamic changes of serum EphA2 protein,resting BOLD fMRI and DTI parameters in the early stage of acute cerebral infarction are correlated with muscle strength,which can be used as a powerful basis for predicting the recovery of limb motor function.

关 键 词：急性脑梗死 肌力 肢体运动功能恢复 Eph受体酪氨酸激酶A2蛋白 静息态血氧水平依赖-功能磁共振成像 磁共振弥散张量成像 

分 类 号：R743.33[医药卫生—神经病学与精神病学]