标准化管壁指数对症状性大脑中动脉狭窄患者发生脑梗死的预测价值研究  

Predictive Value of Normalized Wall Index for Cerebral Infarction in Patients with Symptomatic Middle Cerebral Artery Stenosis

作　　者：张乾营[1] 刘旭红 戴为正[2] 黄莹[1] 何桂凤[1] 傅懋林[2] ZHANG Qianying;LIU Xuhong;DAI Weizheng;HUANG Ying;HE Guifeng;FU Maolin(Department of Radiology,the 910th Hospital,Quanzhou 362000,China;Department of Nneurology,the 910th Hospital,Quanzhou 362000,China)

机构地区：[1]中国人民解放军联勤保障部队第九一〇医院放射诊断科,福建省泉州市362000 [2]中国人民解放军联勤保障部队第九一〇医院神经内科,福建省泉州市362000

出　　处：《实用心脑肺血管病杂志》2022年第8期65-68,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨标准化管壁指数(NWI)对症状性大脑中动脉狭窄患者发生脑梗死的预测价值。方法选取中国人民解放军联勤保障部队第九一〇医院2020年1月至2021年4月收治的48例症状性大脑中动脉狭窄(经MRA检查证实狭窄程度≥50%)患者。将DWI检查阳性患者纳入梗死组,DWI检查阴性患者纳入短暂性脑缺血发作(TIA)组。所有患者分别于住院后第1、30、90、180天行HR-MRI检查。比较两组不同时间NWI,采用ROC曲线分析不同时间NWI对症状性大脑中动脉狭窄患者发生脑梗死的预测价值。结果有8例患者退出本研究,其中梗死组3例、TIA组5例;为使两组患者例数一致,按照随机原则剔除TIA组5例患者,最终共纳入40例患者,梗死组、TIA组各20例。组别与时间在NWI上不存在交互作用(P>0.05);组别、时间在NWI上主效应均显著(P<0.05)。两组患者住院后第180天NWI分别低于本组住院后第1天,且住院后第1、30、90、180天梗死组患者NWI大于TIA组(P<0.05)。ROC曲线分析结果显示,住院后第1、30、90、180天NWI预测症状性大脑中动脉狭窄患者发生脑梗死的AUC分别为0.916〔95%CI(0.831,1.000)〕、0.885〔95%CI(0.782,0.988)〕、0.826〔95%CI(0.690,0.962)〕、0.955〔95%CI(0.732,0.978)〕,最佳截断值分别为0.765、0.705、0.600、0.610,灵敏度分别为85%、85%、85%、85%,特异度分别为90%、85%、75%、85%。结论NWI对症状性大脑中动脉狭窄患者发生脑梗死有较高的预测价值,当症状性大脑中动脉狭窄患者斑块承载动脉的NWI>0.765时,需要警惕脑梗死的发生。Objective To investigate the predictive value of normalized wall index(NWI)for cerebral infarction in patients with symptomatic middle cerebral artery stenosis.Methods A total of 48 patients with symptomatic middle cerebral artery stenosis(stenosis degree≥50%confirmed by MRA)admitted to the 910th Hospital from January 2020 to April 2021 were selected.The patients with positive DWI examination were included in the infarction group,and those with negative DWI examination were included in the teansient ischemic attack(TIA)group.All patients underwent HR-MRI examination on the 1st,30th,90th,and 180th days after hospitalization,respectively.NWI at different time was compared between the two groups.The predictive value of NWI for cerebral infarction in patients with symptomatic middle cerebral artery stenosis was analyzed by ROC curve.Results A total of 8 patients withdrew from the study,including 3 patients in the infarction group and 5 patients in the TIA group.In order to make the number of patients in the two groups consistent,5 patients in the TIA group were excluded according to the principle of randomization,and a total of 40 patients were finally included,with 20 patients in the infarction group and 20 patients in the TIA group.There was no interaction between group and time on NWI(P>0.05);the main effects of group and time on NWI were significant(P<0.05).The NWI at 180th days after hospitalization in the two groups was lower than that at 1st day after hospitalization respectively,and the NWI at 1st,30th,90th,and 180th days after hospitalization in the infarction group was greater than that in the TIA group(P<0.05).ROC curve analysis showed that,the AUC of NWI on the 1st,30th,90th,and 180th days after hospitalization for predicting cerebral infarction in patients with symptomatic middle cerebral artery stenosis was 0.916[95%CI(0.831,1.000)],0.885[95%CI(0.782,0.988)],0.826[95%CI(0.690,0.962)],0.955[95%CI(0.732,0.978)],the best cutoff values were 0.765,0.705,0.600,and 0.610,the sensitivity was 85%,85%,85%,and 8

关 键 词：脑梗死 症状性大脑中动脉狭窄 标准化管壁指数 预测 

分 类 号：R743.33[医药卫生—神经病学与精神病学]