头部CT血管成像联合血清GFAP、S100B在急性脑缺血诊断中的应用价值  

Application value of combined head CT angiography with serum GFAP and S100B in the diagnosis of acute cerebral ischemia

作　　者：车舒平 李安源[1] 李秀丽[1] 司承庆[1] 肖喜刚[1] CHE Shu-ping;LI An-yuan;LI Xiu-li;SI Cheng-qing;XIAO Xi-gang(Department of CT,The First Afiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院CT室,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2024年第3期296-299,313,共5页Journal of Harbin Medical University

摘　　要：目的分析头部CT血管成像(computed tomography angiography,CTA)联合血清胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、S100钙结合蛋白B(S100 calcium-binding protein B,S100B)在急性脑缺血(acute cerebral ischemia,ACI)诊断中的应用价值。方法收集2022年1月~2022年12月在哈尔滨医科大学附属第一医院治疗的ACI患者158例为ACI组,以神经功能缺陷评估量表(national institute of health stroke scale,NIHSS)得分作为依据,又将ACI组分为轻度组(60例)、中度组(52例)以及重度组(46例),同期选择本院正常体检健康者150例作为对照组。采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)比较血清GFAP、S100B的表达水平;应用受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)评价血清GFAP和S100B在ACI诊断中的有效性。四格表法评价CTA、GFAP和S100B在ACI中的联合应用。结果ACI组血清GFAP和S100B明显高于对照组(P<0.05);在重度组中,GFAP和S100B的表达水平较低,中度组明显增高(P<0.05)。关联研究发现,ACI组患者的血清GFAP与S100B之间存在着显著的相关性(P<0.05)。ROC结果显示,血清GFAP和S100B结合对曲线下面积(area under curve,AUC)的检测优于单独检测(P<0.05)。经四格表分析,CTA与GFAP、S100B联合诊断ACI的敏感性和特异度分别为91.8%和84.0%。三者联合诊断特异度高于CTA、GFAP、S100B单独诊断的特异度(P<0.05)。结论ACI患者血清中GFAP、S100B表达水平升高,CTA联合GFAP、S100B可明显提高ACI诊断的价值。Application value of combined head CT angiography with serum GFAP and S100B in the diagnosis of acute cerebral ischemiaCHE Shu-ping;LI An-yuan;LI Xiu-li;SI Cheng-qing;XIAO Xi-gang;Department of CT,The First Affiliated Hospital of Harbin Medical University;Objective To analyze the application value of combined head computed tomography angiography(CTA)with serum glial fibrillary acidic protein(GFAP)and S100 calcium-binding protein B(S100B)in the diagnosis of acute cerebral ischemia(ACI).Methods A total of 158 ACI patients treated at the First Affiliated Hospital of Harbin Medical University from January to December 2022 were designated as the ACI group,with their neurological deficit assessment based on the National Institute of Health Stroke Scale(NIHSS)scores.The ACI group was further divided into mild(60 cases),moderate(52 cases),and severe(46 cases)subgroups.Concurrently,150 healthy individuals undergoing routine medical examination at our institution served as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to compare the expression levels of serum GFAP and S100B.Receiver operating characteristic(ROC)curve analysis was employed to evaluate the diagnostic efficacy of serum GFAP and S100B for ACI.A fourfold table method was applied to assess the combined application of CTA,GFAP,and S100B in ACI.Results Serum GFAP and S100B levels were significantly higher in the ACI group than in the control group(P<0.05);within the severe group,the expression of both proteins was notably increased compared to mild and moderate groups(P<0.05).Correlation studies showed a significant association between serum GFAP and S100B levels in ACI patients(P<0.05).ROC curve showed that the combination of serum GFAP and S100B testing outperformed individual testing for detecting AUC(P<0.05).Fourfold table analysis showed that the sensitivity and specificity of CTA combined with GFAP and S100B for diagnosing ACI were 91.8%and 84.0%,respectively.The combined diagnosis had a higher specificity than monolithically diagnosis u

关 键 词：急性脑缺血 CT血管成像 胶质纤维酸性蛋白 S100钙结合蛋白B 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.3[医药卫生—临床医学]