血清Hcy、THBS-1、颈动脉超声血流参数预测缺血性脑卒中患者预后的价值  

Predictive prognostic value of serum Hcy,THBS-1 and carotid ultrasound blood flow parameters in patients with ischemic stroke

作　　者：杨丽花 丁凌[2] 徐敏 YANG Lihua;DING Ling;XU Min(Department of Ultrasound Imaging,Yangtze River Shipping General Hospital,Wuhan,Hubei 430000,China;Department of Ultrasound,Renhe Hospital Affiliated to China Three Gorges University,Yichang,Hubei 443000,China)

机构地区：[1]长江航运总医院超声影像科,湖北武汉430000 [2]三峡大学附属仁和医院超声科,湖北宜昌443000

出　　处：《国际检验医学杂志》2022年第21期2591-2595,共5页International Journal of Laboratory Medicine

基　　金：2017年湖北省科技计划项目(2017FFB6312)。

摘　　要：目的探讨颈动脉超声血流参数、血清同型半胱氨酸(Hcy)、血小板反应蛋白1(THBS-1)预测缺血性脑卒中患者预后的价值。方法选取2019年2月至2020年6月长江航运总医院109例缺血性脑卒中患者为研究对象,随访6个月,根据预后情况分为预后不良组(27例)与预后良好组(82例)。比较两组颈动脉超声血流参数[颈动脉狭窄处收缩期峰值流速(PSV)、舒张末期流速(EDV)]及血清Hcy、THBS-1水平,比较不同颈动脉狭窄程度患者PSV、EDV、Hcy、THBS-1水平,分析PSV、EDV、Hcy、THBS-1与颈动脉狭窄程度的相关性,分析预后不良的影响因素,采用受试者工作特征(ROC)曲线评价PSV、EDV、Hcy、THBS-1对预后不良的预测价值。结果预后不良组PSV、EDV、Hcy、THBS-1水平高于预后良好组,差异有统计学意义(P<0.05);随颈动脉狭窄程度增加,PSV、EDV、Hcy、THBS-1水平逐渐升高;PSV、EDV、Hcy、THBS-1水平与颈动脉狭窄程度呈正相关(r=0.715、0.803、0.815、0.764,P<0.05);PSV、EDV、Hcy、THBS-1水平升高为缺血性脑卒中患者预后不良的危险因素(P<0.05);PSV、EDV、Hcy、THBS-1联合检测预测预后的曲线下面积最大,为0.925,灵敏度、特异度分别为85.19%、95.12%。结论Hcy、THBS-1、PSV、EDV与缺血性脑卒中患者颈动脉狭窄程度密切相关,能辅助临床预测患者预后情况,为患者病情评估及治疗提供有效参考。Objective To investigate the predictive value of carotid artery ultrasound blood flow parameters,serum homocysteine(Hcy)and thrombospondin 1(THBS-1)in patients with ischemic stroke.Methods A total of 109 ischemic stroke patients in Yangtze River Shipping General Hospital from February 2019 to June 2020 were selected and followed up for 6 months.According to the prognosis,they were divided into poor prognosis group(27 cases)and good prognosis group(82 cases).The levels of carotid ultrasound blood flow parameters[peak systolic velocity(PSV),end-diastolic velocity(EDV)],Hcy and THBS-1 were compared between the two groups.The levels of PSV,EDV,Hcy and THBS-1 in patients with different degrees of carotid stenosis were compared.The relationships between PSV,EDV,Hcy,THBS-1 and the degree of carotid artery stenosis were evaluated,and the influencing factors of poor prognosis were analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of PSV,EDV,Hcy and THBS-1 for prognosis.Results The levels of PSV,EDV,Hcy and THBS-1 in poor prognosis group were higher than those in good prognosis group,the differences were statistically significant(P<0.05).PSV,EDV,Hcy and THBS-1 increased with the degree of carotid stenosis.PSV,EDV,Hcy and THBS-1 correlated positively with the degree of carotid artery stenosis(r=0.715,0.803,0.815,0.764,P<0.05).Elevated levels of PSV,EDV,Hcy and THBS-1 were risk factors for poor prognosis in patients with ischemic stroke(P<0.05).The area under the curve of PSV,EDV,Hcy and THBS-1 combined in predicting prognosis was the lagest,which was 0.925,the sensitivity and specificity were 85.19%and 95.12%respectively.Conclusion Hcy,THBS-1,PSV and EDV relate closely to the degree of carotid artery stenosis in patients with ischemic stroke,which could assist in clinical prediction of prognosis,and provide an effective reference for patients condition assessment and treatment.

关 键 词：缺血性脑卒中 同型半胱氨酸 血小板反应蛋白1 颈动脉狭窄程度 收缩期峰值流速 舒张末期流速 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]