血清同型半胱氨酸联合HR-MRI检测在脑梗死复发中的预测价值  

Predictive value of serum homocysteine combined with HR-MRI in cerebral infarction recurrence

作　　者：杨超[1] 王静莹 汪京京 蒋永泼 YANG Chao;WANG Jingying;WANG Jingjing;JIANG Yongpo(Taizhou Hospital of Zhejiang Province,Zhejiang 317000,China)

机构地区：[1]浙江省台州医院台州市恩泽医疗中心(集团)恩泽医院,台州317000

出　　处：《浙江创伤外科》2023年第5期806-808,832,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的 探究血清同型半胱氨酸(Hcy)联合高分辨率磁共振成像(HR-MRI)检测在脑梗死复发中的预测价值。方法 选择2021年1月至2022年4月在本院就诊的119例脑梗死患者作为研究对象,并根据首次脑梗死后6个月内是否复发分为复发组(21例)和未复发组(98例)。两组均行血清Hcy及HR-MRI检测。比较两组基线资料、血清Hcy及HR-MRI检测结果,采用多因素Logistic回归分析判断影响脑梗死复发的因素,并根据受试者工作特征(ROC)曲线下面积(AUC)分析血清Hcy联合HR-MRI检测对6个月内脑梗死复发的效能。结果 两组患者性别、年龄、身体质量指数(BMI)、高血压、糖尿病、高血脂、吸烟史比较差异无统计学意义(P>0.05);复发组管壁标准化指数(NWI)、斑块内出血(IPH)、斑块纤维帽断裂、Hcy水平明显高于未复发组(P<0.05);两组患者管腔面积(LA)、血管总面积(TVA)、管壁面积(WA)比较差异无统计学意义(P>0.05);NWI、IPH、斑块纤维帽断裂、Hcy是影响脑梗死复发的危险因素(P<0.05);Hcy、NWI+IPH+斑块纤维帽断裂、NWI+IPH+斑块纤维帽断裂+Hcy预测6个月内脑梗死复发的AUC值分别为0.747、0.934、0.955。结论 血清Hcy联合HR-MRI检测在脑梗死复发中具有较好的预测价值。Objective To investigate the predictive value of serum homocysteine(Hcy)combined with high resolution magnetic resonance imaging(HR-MRI)in cerebral infarction recurrence.Methods 119 patient with cerebral infarction who attended to our hospital from January 2021 to April 2022 were selected as research objects,and they were divided into the recurrence group(21 cases)and non-recurrence group(98 cases)according to the recurrence within 6 months after the first cerebral infarction.Baseline data,serum Hcy and HR-MRI detection results,and multivariate Logistic regression analysis of influencing cerebral infarction recurrence were compared between the two groups.The efficacy of serum Hcy combined with HR-MRI detection on cerebral infarction recurrence within 6 months was analyzed according to the area under receiver operating characteristic(ROC)curve(AUC).Results There were no significant differences in gender,age,body mass index(BMI),hypertension,diabetes,hyperlipidemia and smoking history between the two groups(P>0.05).The levels of normalized wall index(NWI),intra plaque hemorrhage(IPH),plaque fibrous cap rupture and Hcy in the recurrent group were significantly higher than those in non-recurrent group(P<0.05).There was no significant difference in lumen area(LA),total vascular area(TVA)and wall area(WA)between the two groups(P>0.05).NWI,IPH,plaque fibrous cap rupture and Hcy were the risk factors for cerebral infarction recurrence(P<0.05).The AUC values of Hcy,NWI+IPH+plaque fibrous cap rupture and NWI+IPH+plaque fibrous cap rupture+Hcy in predicting cerebral infarction recurrence within 6 months were 0.747,0.934 and 0.955,respectively.Conclusion Serum Hcy combined with HR-MRI has good predictive value in the recurrence of cerebral infarction.

关 键 词：血清同型半胱氨酸 颈动脉血管壁磁共振高分辨率成像 脑梗死复发 预测价值 

分 类 号：R589.7[医药卫生—内分泌]