头颈部CTA联合血清Lp⁃PLA2、Hcy在ACI患者颈动脉狭窄及病情中的应用价值  

Application value of head and neck CTA combined with serum Lp⁃PLA2 and Hcy in assessing the degree of carotid artery stenosis and condition in patients with acute cerebral infarction

作　　者：李晨晨 刘辉 刘念念[2] LI Chenchen;LIU Hui;LIU Niannian(Department of Neurology,Qixia District Hospital,Nanjing,Jiangsu,China,210000;Department of Cardiovascular Medicine,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,China,210000)

机构地区：[1]南京市栖霞区医院神经内科,江苏南京210000 [2]南京医科大学第四附属医院心血管内科,江苏南京210000

出　　处：《分子诊断与治疗杂志》2025年第1期145-149,共5页Journal of Molecular Diagnostics and Therapy

基　　金：南京医科大学科技发展基金⁃一般项目(NMUB 20210049)。

摘　　要：目的探究头颈部CT血管成像(CTA)联合血清脂蛋白相关磷脂酶A2(Lp⁃PLA2)、同型半胱氨酸(Hcy)在急性脑梗死(ACI)患者颈动脉狭窄程度及病情中的应用价值。方法选择2021年2月至2024年2月南京市栖霞区医院收治的173例ACI患者为ACI组,选择同期120名健康体检者作为对照组。比较ACI组与对照组、ACI组不同颈动脉狭窄程度及不同病情严重程度患者血清Lp⁃PLA2、Hcy水平。比较CTA单独及与血清Lp⁃PLA2、Hcy水平联合对颈动脉狭窄程度的检出率。采用Spearman相关性分析血清Lp⁃PLA2、Hcy水平与NIHSS评分的相关性,受试者工作特征(ROC)曲线分析血清Lp⁃PLA2、Hcy水平对重度ACI患者的预测价值。结果ACI组血清Lp⁃PLA2、Hcy水平高于对照组,差异有统计学意义(P<0.05)。不同颈动脉狭窄程度血清Lp⁃PLA2、Hcy水平比较,狭窄重度组>狭窄中度组>狭窄轻度组,差异有统计学意义(P<0.05)。CTA联合血清Lp⁃PLA2、Hcy水平在中度狭窄及总狭窄检出率方面效果较好(P<0.05)。不同病情严重程度血清Lp⁃PLA2、Hcy水平比较,重度组>中度组>轻度组,差异有统计学意义(P<0.05)。血清Lp⁃PLA2、Hcy水平与NIHSS评分呈正相关(rs=0.568,0.615,P<0.05)。血清Lp⁃PLA2、Hcy水平联合预测ACI患者的AUC高于Lp⁃PLA2单独预测的AUC(Z=2.858,P=0.004),高于Hcy单独预测的AUC(Z=2.565,P=0.010)。结论ACI患者血清Lp⁃PLA2、Hcy水平升高,与头颈部CTA联合检测能提升颈动脉狭窄检出率,联合检测对重度ACI患者的预测价值较好。Objective To investigate the value of head and neck CT angiography(CTA)combined with serum lipoprotein⁃associated phospholipase A2(Lp⁃PLA2)and homocysteine(Hcy)in the degree of carotid artery stenosis and condition of patients with acute cerebral infarction(ACI).Methods 173 patients with ACI admitted to Qixia District Hospital in Nanjing from February 2021 to February 2024 were selected to be included in the ACI group,and 120 healthy medical checkups during the same period were selected as the control group.Comparison of serum Lp⁃PLA2 and Hcy levels in patients with different degrees of carotid artery stenosis and different severity of disease in both the ACI group and the control group.Comparison of CTA alone and in combination with serum Lp⁃PLA2 and Hcy levels for detection of carotid artery stenosis extent was per⁃formed.The study also analyze the correlation between serum levels of Lp⁃PLA2 and Hcy with NIHSS scores us⁃ing Spearmans correlation analysis.Additionally,it assess the predictive value of serum Lp⁃PLA2 and Hcy levels in patients with severe ACI by the constructing receiver operating characteristic(ROC)curves.Results The serum Lp⁃PLA2 and Hcy levels were higher in the ACI group than in the control group,the difference was statistically significant(P<0.05).Comparison of serum Lp⁃PLA2 and Hcy levels in different degrees of carotid artery stenosis,severe stenosis group>moderate stenosis group>mild stenosis group,the difference was statistically significant(P<0.05).CTA combined with serum Lp⁃PLA2 and Hcy levels was more effective in detecting moderate stenosis and total stenosis rates(P<0.05).Comparison of serum Lp⁃PLA2 and Hcy levels in different disease severity,severe group>moderate group>mild group,the difference was statistically significant(P<0.05).Serum Lp⁃PLA2,Hcy levels positively correlated with NIHSS scores(rs=0.568,0.615,P<0.05).The combination of serum Lp⁃PLA2 and Hcy levels predicted a higher AUC in patients with ACI than did Lp⁃PLA2 alone(Z=2.858,P=0.004)and t

关 键 词：头颈部CT血管成像 脂蛋白相关磷脂酶A2 同型半胱氨酸 急性脑梗死 

分 类 号：R743[医药卫生—神经病学与精神病学]