颈动脉斑块SMI分级联合血清sICAM-1、CysC对进展性缺血性脑卒中的预测价值  

Predictive value of the superb microvasculaRimaging grading of carotid plaque combined with serum sICAM-1 and CysC in progressive ischemic stroke

作　　者：王佳佳 瓦增成[1] 李薇 WANG Jiajia;WA Zengcheng;LI Wei(Department of Ultrasound,Qinghai Red Cross Hospital,Qinghai,Xining 810000,China)

机构地区：[1]青海红十字医院超声科,西宁市810000 [2]青海省第五人民医院神经内科

出　　处：《河北医药》2024年第11期1670-1673,共4页Hebei Medical Journal

摘　　要：目的探究颈动脉斑块超微血管成像(SMI)分级联合血清可溶性细胞间黏附分子1(sICAM-1)、胱抑素C(CysC)对进展性缺血性脑卒中(PIS)的预测价值。方法纳入2020年3月至2022年11月青海红十字医院神经内科收治且有颈动脉斑块的急性缺血性脑卒中患者216例进行回顾性分析,分为PIS组(66例)和非进展性缺血性脑卒中(NPIS)组(150例)。Logistic回归分析影响PIS的独立危险因素。受试者工作特征(ROC)曲线分析颈动脉斑块SMI分级联合血清sICAM-1、CysC对PIS的诊断价值。结果与NPIS组相比,PIS组同型半胱氨酸(Hcy)水平、纤维蛋白原(FIB)水平、sICAM-1水平、CysC水平、入院美国国立卫生研究院卒中量表(NIHSS)评分较高(P<0.05)。PIS组和NPIS组颈动脉斑块SMI分级比较,差异有统计学意义(P<0.05)。Logistic回归分析发现入院NIHSS评分、sICAM-1、CysC、SMI分级是PIS的独立危险因素(P<0.05)。ROC曲线分析显示,颈动脉斑块SMI分级诊断PIS的曲线下面积(AUC)为0.842,血清sICAM-1、CysC水平诊断PIS的AUC分别为0.803、0.802,三者联合诊断PIS的AUC为0.959。结论PIS患者血清sICAM-1、CysC水平显著升高,颈动脉斑块SMI分级联合血清sICAM-1、CysC可提高预测PIS的效能。Objective To investigate the predictive value of the superb microvasculaRimaging(SMI)grading of carotid plaque combined with serum soluble intercellulaRadhesion molecule 1(sICAM-1)and cystatin C(CysC)in progressive ischemic stroke(PIS).Methods It was a retrospective analysis involving 216 acute ischemic stroke patients with carotid artery plaques admitted to the Neurology Department of Qinghai Red Cross Hospital from March 2020 to NovembeR2022.They were divided into PIS group(66 cases)and non-PIS group(NPIS,150 cases).Logistic regression was used to analyze the independent risk factors foRPIS.ReceiveRoperating characteristic(ROC)curve was used to analyze the diagnostic value of the SMI grading of carotid plaque combined with serum sICAM-1 and CysC in PIS.Results Compared with those of the NPIS group,patients in the PIS group had significantly higheRhomocysteine(Hcy),fibrinogen(FIB),sICAM-1 and CysC levels,and the National Institutes of Health Stroke Scale(NIHSS)scores on admission(P<0.05).There was a significant difference in the SMI grading of carotid plaque between PIS group and NPIS group(P<0.05).Logistic regression analysis found that the NIHSS score,sICAM-1,CysC,and SMI grading of carotid plaque on admission were independent risk factors foRPIS(P<0.05).ROC curve analysis showed that the area undeRthe curve(AUC)of the SMI grading of carotid plaque in diagnosing PIS was 0.842,and that of serum sICAM-1 and CysC levels was 0.803 and 0.802,respectively.The AUC of the SMI grading of carotid plaque combined with serum sICAM-1 and CysC in diagnosing PIS was 0.959.Conclusion Serum sICAM-1 and CysC levels are significantly elevated in PIS patients,and the SMI grading of carotid plaque combined with serum sICAM-1 and CysC can improve the performance in predicting PIS.

关 键 词：超微血管成像技术 进展性缺血性脑卒中 颈动脉斑块 可溶性细胞间粘附分子1 胱抑素C 

分 类 号：R322.121[医药卫生—人体解剖和组织胚胎学]