CTP参数联合血Hcy、hs-CRP检测预测TIA进展为ACI的价值  

Predictive Value of CTP Parameters Combined with Serum Hcy and hs-CRP for TIA Progression to ACI

作　　者：李鹏 李文 张文静 毕研翠 周涛 LI Peng;LI Wen;ZHANG Wen-jing;BI Yan-cui;ZHOU Tao(Department of Imaging,People's Hospital Affiliated to Shandong First Medical University,Jinan 271100,Shandong Province,China)

机构地区：[1]山东第一医科大学附属人民医院影像科,山东济南271100

出　　处：《中国CT和MRI杂志》2025年第1期4-6,共3页Chinese Journal of CT and MRI

基　　金：济南市2021年科技创新发展计划(202134053)。

摘　　要：目的 分析计算机断层扫描灌注成像(CTR)参数联合血同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)检测预测短暂性脑缺血发作(TIA)进展为急性脑梗死(ACI)的价值。方法 将2021年4月至2023年4月在我院收治的85例TIA患者纳入为此次研究对象,所有入组患者均于入院24h内完成CTP检查,并检测血H cy、hs-C RP水平,根据患者发病后7d内是否进展为ACI将入组对象分组为ACI组、非ACI组。比较ACI组、非ACI组一般资料、CTP参数[脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)、达峰时间(TTP)]、血Hcy、hs-CRP水平,绘制ROC分析上述指标检测对TIA进展为ACI的预测效能。结果85例TIA患者7d内16例进展为ACI,ACI发生率为18.82%(16/85)。ACI组合并高血压、合并高脂血症比例明显高于非ACI组(P<0.05)。ACI组CBV、CBF水平低于非ACI组, MTT、TTP高于非ACI组(P<0.05)。ACI组血Hcy、hs-CRP水平高于非ACI组(P<0.05)。CTP参数(CBV、CBF、 MTT、TTP)、血Hcy、hsC R P及联合检测预测TIA进展为ACI的曲线下面积(AUC)均>0.70,预测效能较好,且以联合最佳。根据ROC曲线得出CTP参数(CBV、CBF、MTT、TTP)、血Hcy、hs-CRP的cut-off值分别为2.97mL/100 g、34.19 mL/min·100 g、8.75 s、12.65s、16.14μmol/L和5.27 mg/L。结论 CTP参数联合血Hcy、hs-CRP检测对预测TIA进展为ACI有一定的应用价值,且以联合效果更佳。Objective To analyze the predictive value of computed tomography perfusion(CTP)parameters combined with serum homocysteine(Hcy)and hypersensitive C-rea ctive protein(hs-CRP)for tra nsient ischemic attack(TIA)progression to acute cerebral infarction(ACI).Methods A total of 85 patients with TIA admitted to the hospital were en rolled as the resea rch objects between April 2021 and April 2023.All underwent CTP within 24h after admission.The levels of serum Hcy and hs-CRP were detected.According to presence or absence of TIA progression to ACI within 7d after onset,patients were divided into ACI group and non-ACI group.The general data,CTP parameters(CBV,CBF,MTT,TTP),serum Hcy and hs-CRP were compared between the two groups,and predictive efficiency of the above indexes for TIA progression to ACI was analyzed by ROC curves.Results In the 85 TIA patients,there were 16 cases[18.82%(16/85)]with TIA progression to ACI within 7d after onset.The proportions of hypertension and hyperlipidemia in ACI group were significantly higher than that in non-ACI group(P<0.05).CBV and CBF in ACI group were lower than those in non-ACI group,while MTT and TTP were longer than those in non-ACI group(P<0.05).The levels of serum Hcy and hs-CRP in ACI group were higher than those in non-ACI group(P<0.05).The area under the cu rve(AUC)values of CTP parameters(CBV,CBF,MTT,TTP),serum Hcy,hs-CRP and combined detection for predicting TIA progression to ACI were all>0.70,showing good predictive efficiency,and predictive efficiency of combined detection was the highest.According to ROC curves,cut-off values of CTP parameters(CBV,CBF,MTT,TTP),serum Hcy,hs-CRP were 2.97 mL/100 g,34.19 mL/min-100 g,8.75 s,12.65 s,16.14μmol/L and 5.27mg/L,respectively.Condusion CTP parameters combined with serum Hcy and hs-CRP have certain application value in predicting TIA progression to ACI,and predictive efficiency of combined detection is better.

关 键 词：计算机断层扫描灌注成像 血同型半胱氨酸 C反应蛋白 短暂性脑缺血发作 急性脑梗死 预测效能 

分 类 号：R743.31[医药卫生—神经病学与精神病学]