液体衰减反转恢复序列高信号血管征可预测急性脑梗死患者短期神经功能预后  

Fluid-attenuated inversion recovery sequence high signal vascular sign could predict the short-term neurological function prognosis in patients with acute cerebral infarction

作　　者：乔刚 沈文超[1] 王欣 王宁 赵京 QIAO Gang;SHEN Wen-chao;WANG Xin;WANG Ning;ZHAO Jing(Department of Radiology,The 82nd Group Army Hospital of the Chinese People's Liberation Army,Hebei Baoding 071000,China;Department of Radiology,Tangshan Harbor Economic Development Zone Hospital,Hebei Tangshan 063099,China;Department of Internal Medicine,Kailuan General Hospital Linxi Hospital,Hebei Tangshan 063001,China;Department of Internal Medicine,Baoding Second Hospital,Hebei Baoding,071051,China)

机构地区：[1]中国人民解放军陆军第八十二集团军医院医学影像科,河北保定071000 [2]唐山海港经济开发区医院影像科,河北唐山063099 [3]开滦总医院林西医院内科,河北唐山063001 [4]保定市第二医院内科,河北保定071051

出　　处：《内科急危重症杂志》2024年第2期138-141,150,共5页Journal of Critical Care In Internal Medicine

基　　金：河北保定市科技计划项目(2041ZF341)。

摘　　要：目的:探讨液体衰减反转恢复序列(Flair)高信号血管征联合中性粒细胞计数对急性脑梗死(ACI)患者短期神经功能预后的预测价值。方法:选取96例经头颅磁共振确诊的ACI患者,入院时采用美国国立卫生院神经功能缺损评分量表(NIHSS)进行神经功能缺损评分,根据NIHSS评分将其分为轻度组(41例)、中度组(30例)和重度组(25例)。所有患者均进行磁共振检查,对Flair序列上高信号血管征进行评分,分析Flair高信号血管征、中性粒细胞计数与ACI患者短期神经功能预后的关系。患者发病6个月后,采用改变Rankin量表(mRS)评分将其分为预后良好组(81例)和预后不良组(15例)。结果:重度组患者年龄≥60岁、高血压及冠心病史的患者比例、入院时NIHSS评分、病灶直径、中性粒细胞计数均高于中度组和轻度组,而Flair高信号血管征评分低于中度组和轻度组(P均<0.05)。多因素logistic回归分析显示,年龄≥60岁、高血压及冠心病史、入院时NIHSS评分≥12分(OR=1.267,95%CI:1.140~1.409)、中性粒细胞计数升高(OR=1.719,95%CI:1.351~2.188)、Flair高信号血管征评分<4.76分(OR=2.190,95%CI:1.437~3.338)是影响ACI患者神经功能缺损的独立危险因素(P均<0.05)。预后不良组患者Flair高信号血管征评分较低,而中性粒细胞计数较高(P均<0.05)。以预后不良为因变量绘制受试者工作特征(ROC)曲线,结果显示Flair高信号血管征评分截断值为4.76分时,预测ACI患者短期神经功能预后的ROC曲线下面积为0.76(95%CI:0.745~0.826),敏感度和特异度分别为70.33%和64.33%;中性粒细胞计数截断值为5.82×10^(9)/L时,预测ACI患者短期神经功能预后的ROC曲线下面积为0.74(95%CI:0.723~0.814),敏感度和特异度分别为77.56%和63.24%;两者联合预测ACI患者短期神经功能预后的ROC曲线下面积为0.81(95%CI:0.839~0.876),敏感度和特异度分别为80.25%和63.46%。结论:Flair高信号血管征评分降低,中性粒细胞�Objective:To investigate the predictive value of high signal vascular sign of fluid-attenuated inverse recovery sequence(Flair)combined with neutrophil count in short-term neurological prognosis in patients with acute cerebral infarction(ACI).Methods:A total of 96 patients with ACI diagnosed by head magnetic resonance were selected and scored by the National Institutes of Health Neurological Impairment Scale(NIHSS)at admission.They were divided into mild group(41 cases),moderate group(30 cases)and severe group(25 cases)according to the NIHSS scores.All patients were examined by magnetic resonance imaging,and Flair high signal vascular signs were scored to analyze the relationship between Flair high signal vascular signs,neutrophil counts and short-term neurological function prognosis in ACI patients.At 6th month after the onset of the disease,the patients were divided into a good prognosis group(81 cases)and a poor prognosis group(15 cases)by using the modified Rankin scale(mRS)score.Results:The proportion of patients aged≥60 years and having history of hypertension and coronary heart disease,NIHSS score at admission,lesion diameter and neutrophil count in severe group were higher than those in moderate and mild groups,while the score of Flair high signal vascular sign in severe group was lower than that in moderate and mild groups(all P<0.05).Multivariate logistic regression analysis showed that Age≥60 years,history of hypertension and coronary heart disease,NIHSS score≥12 points at admission(OR=1.267,95%C1:1.140-1.409),elevated neutrophil count(OR=1.719,95%CI:1.351-2.188),Flair high signal vascular score<4.76 points(OR=2.190,95%C1:1.437-3.338)were independent risk factors for neurological impairment in ACI patients(all P<0.05).Flair high signal vascular scores were lower and neutrophil counts were higher in the poor prognosis group(all P<0.05).Receiver operating characteristic(ROC)curve was drawn with poor prognosis as the dependent variable.The results showed that when the cut-off value of Flair high sig

关 键 词：液体衰减反转恢复序列高信号血管征 中性粒细胞计数 急性脑梗死 神经功能 短期预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]