双源CTA联合血清Hcy、CysC对颅内动脉瘤的诊断价值  

The Diagnostic Value of Dual Source CTA Combined with Serum Hcy and CysC for Intracranial Aneurysms

作　　者：陈枫 朱晓强 郁明惠 CHEN Feng;ZHU Xiaoqiang;YU Minghui(Department of Imaging,Suzhou Integrated Traditional Chinese andWestern Medicine Hospital,Suzhou 215101,China;Department of Neurosurgery,Suzhou Integrated Traditional Chinese andWestern Medicine Hospital,Suzhou 215101,China)

机构地区：[1]苏州市中西医结合医院影像科,江苏苏州215101 [2]苏州市中西医结合医院神经外科,江苏苏州215101

出　　处：《标记免疫分析与临床》2024年第4期622-626,652,共6页Labeled Immunoassays and Clinical Medicine

基　　金：苏州市2018年度科技发展计划(民生科技-医疗卫生应用基础研究[第二批])项目(编号:SYSD2018132)。

摘　　要：目的探讨双源CT血管造影(CTA)联合血清同型半胱氨酸(Hcy)、胱抑素C(CysC)对颅内动脉瘤(IA)的诊断价值。方法选取2021年5月至2023年5月在本院收治的疑似IA的125例患者作为研究对象,经数字减影血管造影(DSA)诊断证实78例IA患者作为病例组,其余47例患者作为对照组,比较两组血清Hcy、CysC水平。ROC分析双源CTA联合血清Hcy、CysC水平对IA的诊断价值。Logistic分析影响患者发生IA的因素。结果病例组通过双源CTA检测出61例IA患者,灵敏度为78.21%,特异性为80.85%。病例组血清Hcy、CysC水平比对照组高(P<0.05)。病例组高血压、高血脂患者比例比对照组高(P<0.05)。ROC分析显示,血清Hcy、CysC分别辅助诊断是否发生IA的曲线下面积(AUC)是0.807(95%CI 0.730~0.884)、0.787(95%CI 0.705~0.869),双源CTA诊断IA的AUC是0.795(95%CI 0.711~0.879),3者联合诊断的AUC为0.933(95%CI 0.891~0.974),均优于各自单独检测(Z=2.845、3.109、2.884,P<0.05)。多因素分析显示,血清Hcy、CysC是影响患者发生IA的危险因素(P<0.05)。结论双源CTA联合血清Hcy、CysC对IA有一定的临床辅助诊断价值。Objective To explore the diagnostic value of dual source CT angiography(CTA)combined with serum homocysteine(Hcy)and cystatin C(CysC)for intracranial aneurysm(IA).Methods From May,2021 to May,2023,125 suspected IA patients admitted to our hospital were collected as the study subjects.78 IA patients confirmed by digital subtraction angiography(DSA)diagnosis were selected as the case group,while the remaining 47 patients were as the control group.Serum Hcy and CysC levels of the two groups were compared.Receiver operating characteristic curve(ROC)was drawn to evaluate the diagnostic value of dual source CTA combined with serum Hcy and CysC levels for IA.Logistic model was applied to identify the factors that affected the occurrence of IA in patients.Results The case group detected 61 IA patients through dual source CTA,with a sensitivity of 78.21%and a specificity of 80.85%.Serum Hcy and CysC levels in the case group were higher than those in the control group(P<0.05).The proportions of patients with hypertension and hyperlipidemia in the case group were higher than those in the control group(P<0.05).ROC analysis showed that the area under the curve(AUC)of serum Hcy and CysC were 0.807(95%CI 0.730-0.884)and 0.787(95%CI 0.705-0.869)for assisting in the diagnosis of IA,respectively.AUC of dual source CTA diagnosis of IA was 0.795(95%CI 0.711-0.879),and AUC of the combined diagnosis of the three markers was 0.933(95%CI 0.891-0.974),both of which were superior to their individual detection(Z=2.845,3.109,2.884,P<0.05).Multivariate analysis showed that serum Hcy and CysC were risk factors affecting the occurrence of IA in patients(P<0.05).Conclusion The combination of dual source CTA and serum Hcy and CysC has certain clinical auxiliary diagnostic value for IA.

关 键 词：颅内动脉瘤 双源CT血管造影 同型半胱氨酸 胱抑素C 诊断价值 

分 类 号：R732.21[医药卫生—肿瘤]