实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
PRACTICAL JOURNAL OF CARDIAC CEREBRAL PNEUMAL AND VASCULAR DISEASE
2015年
1期
110-112
,共3页
冯兆章%张远鸿%腾录霞%钟向阳%黄瑞瑜%骆玉辉
馮兆章%張遠鴻%騰錄霞%鐘嚮暘%黃瑞瑜%駱玉輝
풍조장%장원홍%등록하%종향양%황서유%락옥휘
短暂性脑缺血发作%脑梗死%CT血管造影%ABCD2评分
短暫性腦缺血髮作%腦梗死%CT血管造影%ABCD2評分
단잠성뇌결혈발작%뇌경사%CT혈관조영%ABCD2평분
Ischemic attack,transient%Cerebral infarction%CT angiography%ABCD2 score
目的:研究CT血管造影( CTA)检查联合ABCD2评分对短暂性脑缺血发作( TIA)后早期脑梗死的预测价值。方法选择2013年4月—2014年5月鹤山市人民医院收治的TIA患者200例,根据7 d内是否发生脑梗死将患者分为脑梗死组和非脑梗死组,各100例。采用CTA检测患者颈动脉狭窄程度、ABCD2评分评估患者整体病情、酶联免疫吸附法检测患者血清基质金属蛋白酶9( MMP-9)和金属蛋白酶组织抑制剂1( TIMP1)。评价CTA检查、ABCD2评分单独检测与联合检测对脑梗死的诊断价值。结果梗死组患者颈动脉狭窄程度、ABCD2评分及CTA检查狭窄阳性率、ABCD2评分阳性率均高于非梗死组〔(75.85±8.96)%比(26.78±3.18)%,(5.96±0.67)分比(2.54±0.35),88%比12%,86%比14%〕。ABCD2评分+CTA检查判断脑梗死的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为95.00%、96.00%、95.50%、95.96%、95.05%,均高于 CTA 检查和 ABCD2评分单独检查(P﹤0.05);CTA检查狭窄阳性和ABCD2评分阳性患者血清MMP-9水平分别高于阴性患者、TIMP1水平分别低于阴性患者(P﹤0.05)。结论 CTA检查联合ABCD2评分能够相对准确且灵敏地预测TIA后早期脑梗死的发生,同时可以反映患者炎性反应程度。
目的:研究CT血管造影( CTA)檢查聯閤ABCD2評分對短暫性腦缺血髮作( TIA)後早期腦梗死的預測價值。方法選擇2013年4月—2014年5月鶴山市人民醫院收治的TIA患者200例,根據7 d內是否髮生腦梗死將患者分為腦梗死組和非腦梗死組,各100例。採用CTA檢測患者頸動脈狹窄程度、ABCD2評分評估患者整體病情、酶聯免疫吸附法檢測患者血清基質金屬蛋白酶9( MMP-9)和金屬蛋白酶組織抑製劑1( TIMP1)。評價CTA檢查、ABCD2評分單獨檢測與聯閤檢測對腦梗死的診斷價值。結果梗死組患者頸動脈狹窄程度、ABCD2評分及CTA檢查狹窄暘性率、ABCD2評分暘性率均高于非梗死組〔(75.85±8.96)%比(26.78±3.18)%,(5.96±0.67)分比(2.54±0.35),88%比12%,86%比14%〕。ABCD2評分+CTA檢查判斷腦梗死的靈敏度、特異度、準確度、暘性預測值、陰性預測值分彆為95.00%、96.00%、95.50%、95.96%、95.05%,均高于 CTA 檢查和 ABCD2評分單獨檢查(P﹤0.05);CTA檢查狹窄暘性和ABCD2評分暘性患者血清MMP-9水平分彆高于陰性患者、TIMP1水平分彆低于陰性患者(P﹤0.05)。結論 CTA檢查聯閤ABCD2評分能夠相對準確且靈敏地預測TIA後早期腦梗死的髮生,同時可以反映患者炎性反應程度。
목적:연구CT혈관조영( CTA)검사연합ABCD2평분대단잠성뇌결혈발작( TIA)후조기뇌경사적예측개치。방법선택2013년4월—2014년5월학산시인민의원수치적TIA환자200례,근거7 d내시부발생뇌경사장환자분위뇌경사조화비뇌경사조,각100례。채용CTA검측환자경동맥협착정도、ABCD2평분평고환자정체병정、매련면역흡부법검측환자혈청기질금속단백매9( MMP-9)화금속단백매조직억제제1( TIMP1)。평개CTA검사、ABCD2평분단독검측여연합검측대뇌경사적진단개치。결과경사조환자경동맥협착정도、ABCD2평분급CTA검사협착양성솔、ABCD2평분양성솔균고우비경사조〔(75.85±8.96)%비(26.78±3.18)%,(5.96±0.67)분비(2.54±0.35),88%비12%,86%비14%〕。ABCD2평분+CTA검사판단뇌경사적령민도、특이도、준학도、양성예측치、음성예측치분별위95.00%、96.00%、95.50%、95.96%、95.05%,균고우 CTA 검사화 ABCD2평분단독검사(P﹤0.05);CTA검사협착양성화ABCD2평분양성환자혈청MMP-9수평분별고우음성환자、TIMP1수평분별저우음성환자(P﹤0.05)。결론 CTA검사연합ABCD2평분능구상대준학차령민지예측TIA후조기뇌경사적발생,동시가이반영환자염성반응정도。
Objective To investigate the predictive value of CT angiography( CTA) combined with ABCD2 score on early cerebral infarction after transient ischemic attack ( TIA ). Methods A total of 200 TIA patients were selected in the People's Hospital of Heshan from April 2013 to May 2014,and they were divided into A group(with cerebral infarction)and B group( without cerebral infarction) according to the incidence of cerebral infarction within 7 days,each of 100 cases. CTA was used to examine carotid artery stenosis,ABCD2 score was used to evaluate illness,serum levels of MMP-9 and TIPM1 were detected by ELIXA. Results The carotid artery stenosis degree,ABCD2 score,positive rate of CTA and ABCD2 score was higher than that of control group,respectively〔(75. 85 ± 8. 96)% vs. (26. 78 ± 3. 18)%,(5. 96 ± 0. 67)vs. (2. 54 ± 0. 35),88% vs. 12%,86% vs. 14%〕(P﹤0. 05). The sensitivity,specificity,accuracy,positive predictive value,negative predictive value of CTA and ABCD2 score combined examination on predicting early cerebral infarction after TIA was 95. 00%, 96. 00%,95. 50%,95. 96%,95. 05%, respectively, was higher than that of single CTA examination or ABCD2 score, respectively(P﹤0. 05). Xerum MMP-9 level of patients with positive result of CTA examination or ABCD2 score was higher than that of patients with negative result of CTA examination or ABCD2 score,while serum TIPM1 level of patients with positive result of CTA examination or ABCD2 score was lower than that of patients with negative result of CTA examination or ABCD2 score (P﹤0. 05). Conclusion Combined examination of CTA and ABCD2 score can accurately and sensitively predict the incidence of early cerebral infarction after TIA,reflect the degree of inflammatory reaction.