CT灌注成像参数联合ABCD2评分预测TIA患者短期脑卒中发生风险的价值

doi:10.3969/j.issn.1671-7171.2023.01.024

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1136 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 【目的】 探讨CT灌注成像(CTP)参数联合ABCD2评分预测短暂性脑缺血发作(TIA)患者短期内发生脑卒中的价值。【方法】 91例TIA患者,根据入院7 d后是否发生脑卒中将其分为脑卒中组(n=33)与非脑卒中组(n=58)。比较两组患者一般资料、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血栓调节蛋白(TM)、D-二聚体(D-D)、空腹血糖、ABCD2评分及CTP参数[脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)以及达峰时间(TTP)]水平,通过受试者工作特征(ROC)曲线分析相关指标预测TIA患者短期内发生脑卒中的价值,采用多因素Logistic回归分析TIA患者短期内发生脑卒中的危险因素。【结果】 两组性别、年龄、合并症、体重指数(BMI)、饮酒史、LDL-C、HDL-C、CBV、空腹血糖比较,差异均无统计学意义(P>0.05);脑卒中组TM、D-D、TTP、MTT、ABCD2评分均显著高于非脑卒中组,CBF显著低于非脑卒中组(P<0.05);经ROC分析,TM≥28.918 g/L、D-D≥487.548 mg/L、TTP≥15.297 s、MTT≥4.340 s、ABCD2评分≥4.632分、CBF≤28.313 mL/(100 g·min)是预测TIA患者短期内发生脑卒中的最佳截断值(均P<0.05);Logistic回归分析显示上述指标是TIA患者短期内发生脑卒中的危险因素(P<0.05)。【结论】 TIA患者短期内发生脑卒中与TM、D-D、TTP、MTT、CBF、ABCD2评分显著有关,应对其密切监测。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	赵舒平
	王文辉
	王彦平

关键词 ：脑缺血发作, 短暂性/影像诊断, 卒中, 体层摄影术, 螺旋计算机

Abstract：【Objective】 To investigate the value of CT perfusion imaging (CTP) parameters combined with ABCD2 score in predicting stroke in patients with transient ischemic attack (TIA).【Methods】 A total of 91 TIA patients were divided into stroke group (n=33) and non stroke group (n=58) according to whether stroke occurred 7 days after admission.The general data,low-density cholesterol (LDL-C),high-density cholesterol (HDL-C),thrombomodulin (TM),D-dimer (D-D),fasting blood glucose,ABCD2 score and CTP parameters (cerebral blood volume (CBV),cerebral blood flow (CBF),mean transit time (MTT) and time to peak (TTP) of the two groups were compared.The value of short-term stroke in TIA patients was predicted by analyzing the relevant indicators of the reciever's oprating characteristic curve (ROC),and the risk factors of short-term stroke in TIA patients were identified by multivariate logistic regression analysis.【Results】 There was no significant difference in sex,age,comorbidity,body mass index (BMI),drinking history,LDL-C,HDL-C,CBV and fasting blood glucose between the two groups (P>0.05); The scores of TM,D-D,TTP,MTT and ABCD2 in stroke group were significantly higher than those in non stroke group,and the CBF was significantly lower than that in non stroke group (P<0.05); ROC analysis showed that TM ≥ 28.918 g/L,D-D ≥487.548 mg/L,TTP ≥15.297 s,MTT ≥ 4.340 s,ABCD2 score ≥ 4.632,CBF ≤ 28.313 mL/(100 g·min) were the best cutoff values for predicting stroke in TIA patients in the short term (all P<0.05); Logistic regression analysis showed that the above indicators and data were risk factors for stroke in TIA patients in the short term (P<0.05).【Conclusion】 The occurrence of stroke in TIA patients in the short term is related to TM,D-D,TTP,MTT,CBF,ABCD2 scores,which should be closely monitored.

Key words： Ischemic Attack, Transient/DG Stroke Tomography, Spiral Computed

收稿日期: 2022-07-21

中图分类号:

R743.31

通讯作者: *,E-mail:zspwwh@outlook.com

引用本文:

赵舒平, 王文辉, 王彦平. CT灌注成像参数联合ABCD2评分预测TIA患者短期脑卒中发生风险的价值[J]. 医学临床研究, 2023, 40(1): 81-84.
ZHAO Shu-ping, WANG Wen-hui, WANG Yan-ping. The Value of CT Perfusion Imaging Parameters Combined with ABCD2 Score in Predicting Short-term Stroke Risk in TIA Patients. JOURNAL OF CLINICAL RESEARCH, 2023, 40(1): 81-84.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.01.024 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I1/81

[1] DALLI L L,KIM J,CADILHAC D A,et al.Greater adherence to secondary prevention medications improves survival after stroke or transient ischemic attack:a linked registry study[J].Stroke,2021,52(11):3569-3577.
[2] 许涛,郭静,由秀,等.磁共振成像和CT对短暂性脑缺血发作患者的急性脑梗死诊断价值研究[J].中国医学装备,2021,18(1):54-58.
[3] 王斌,姚振威,杨芮,等.3D-ASL联合ABCD2评分与DSC-PWI联合ABCD2评分评估TIA的对比研究[J].中国医学计算机成像杂志,2021,27(3):185-189.
[4] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J].中华神经科杂志,2015,48(4):258-273.
[5] HERMANN D M,DOEPPNER T R,GIEBEL B .New light on the horizon:extracellular vesicles as diagnostic tool in transient ischemic attack and ischemic stroke[J].Stroke,2021,52(10):3348-3350.
[6] WEI M,XUE X,PAN Y,et al.Relationship between thrombomodulin gene polymorphism and susceptibility to venous thromboembolism:A protocol for systematic review and meta-analysis[J].Medicine,2021,100(11):e25001.
[7] 郭俊,许强宏.脓毒症患者血栓调节蛋白和纤溶酶原激活物抑制剂-1及内皮细胞损伤程度的研究初探[J].中华内科杂志,2021,60(2):143-146.
[8] LIU Y,LEI Z,CHAI H,et al.Thrombomodulin-mediated inhibition of neutrophil extracellular trap formation alleviates hepatic ischemia/reperfusion injury by blocking TLR4 in rats subjected to liver transplantation[J].Transplantation,2022,106(2):e126-e140.
[9] 王海霞,张丽娜,梁红日,等.短暂性脑缺血发作后脑梗死发生影响因素及血栓调节蛋白对其预测价值研究[J].实用心脑肺血管病杂志,2020,28(6):52-56.
[10] WANG Y,XIAO Y,DENG X,et al.Cardiac thrombus and stroke in a child with Mycoplasma pneumoniae pneumonia:A case report[J].Medicine,2021,100(5):e24297.
[11] TAKAHASHI K,WATANABE M,KANIE Y,et al.Significance of D-dimer-based screening for detecting pre-operative venous thromboembolism in patients with esophageal cancer after neoadjuvant chemotherapy[J].Int J Clin Oncol,2021,26(6):1083-1090.
[12] 王小凤,谢卡飞,钱群飞,等.超声造影评估颈动脉斑块新生血管联合ABCD3评分、D-二聚体水平对短暂性脑缺血发作早期脑卒中风险的预测价值[J].中国医刊,2022,57(3):316-319.
[13] 王青川,马国诏,王爱华.短暂性脑缺血发作短期内脑梗死发生风险的预测[J].中华保健医学杂志,2019,21(1):13-16.
[14] 张要宇,王博.磁共振灌注成像与CT灌注成像在老年缺血性脑血管病患者中的应用[J].中国CT和MRI杂志,2020,18(9):14-16.
[15] 陆梦祎,郭欠欠,李盼洁.CT灌注成像联合CT血管造影在慢性脑供血不足患者中的应用分析[J].山西医药杂志,2021,50(18):2654-2655.