CTA对后循环脑梗死患者椎基底动脉狭窄的评估价值及其与血清生化指标的相关性

The evaluation value of CTA for vertebrobasilar artery stenosis in patients with posterior circulation cerebral infarction and its correlation with serum biochemical indexes

目的:研究CTA对后循环脑梗死患者椎基底动脉狭窄的评估价值及其与血清生化指标的相关性。方法:选择2014年6月~2017年2月期间因椎基底动脉狭窄在马鞍山十七冶医院就诊的148例患者作为研究对象,根据影像学检查分为脑梗死组和短暂性脑缺血发作(TIA)组。采用CTA评估椎基底动脉粥样斑块的性质,采用酶联免疫吸附试剂盒测定神经功能损伤标志物、炎症反应相关分子、斑块性质相关蛋白酶分子的含量。结果:脑梗死组患者后循环斑块检出率显著高于TIA组且不稳定斑块、纤维斑块、钙化斑块的检出率高于TIA组;脑梗死组中不稳定斑块、纤维斑块、钙化斑块患者血清中NSE、S100B、UCH-L1、GFAP、ICAM-1、VCAM-1、PECAM-1、VE-cadherin、YKL-40、CatS、MMP9、MMP10、ADAMTS12的含量均高于TIA组;脑梗死组中不稳定斑块、纤维斑块患者血清中NSE、S100B、UCH-L1、GFAP、ICAM-1、VCAM-1、PECAM-1、VE-cadherin、YKL-40、CatS、MMP9、MMP10、ADAMTS12的含量均高于钙化斑块患者,不稳定斑块患者血清中NSE、S100B、UCH-L1、GFAP、ICAM-1、VCAM-1、PECAM-1、VE-cadherin、YKL-40、CatS、MMP9、MMP10、ADAMTS12的含量均高于纤维斑块患者。结论:CTA能够准确评估后循环脑梗死患者椎基底动脉粥样斑块的性质且与神经损伤程度、斑块性质变化过程密切相关。

Objective:To study the evaluation value of CTA for vertebrobasilar artery stenosis in patients with posterior circulation cerebral infarction and its correlation with serum biochemical indexes.Methods:148 patients who were treated in Maanshan Shiqiye Hospital between June 2014 and February 2017 due to vertebrobasilar artery stenosis were selected as the research subjects and divided into cerebral infarction group and transient ischemic attack(TIA)group according to the imageological examination.CTA was used to evaluate vertebrobasilar atherosclerotic plaque properties,and enzyme-linked immunosorbent assay kit was used to determine the levels of nerve injury markers,inflammatory response-related molecules and plaque property-related protease molecules.Results:The positive rate of posterior circulation plaque in cerebral infarction group was obviously higher than that in TIA group,and the positive rate of unstable plaque,fibrous plaque and calcified plaque were higher than those in TIA group;serum NSE,S100 B,UCH-L1,GFAP,ICAM-1,VCAM-1,PECAM-1,VE-cadherin,YKL-40,CatS,MMP9,MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque,fibrous plaque and calcified plaque were all higher than those of TIA group;serum NSE,S100 B,UCH-L1,GFAP,ICAM-1,VCAM-1,PECAM-1,VE-cadherin,YKL-40,CatS,MMP9,MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque and fibrous plaque were all higher than those of patients with calcified plaque,and serum NSE,S100 B,UCHL1,GFAP,ICAM-1,VCAM-1,PECAM-1,VE-cadherin,YKL-40,CatS,MMP9,MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque were all higher than those of patients with fibrous plaque.Conclusions:CTA can accurately assess the property of vertebrobasilar atherosclerotic plaque in patients with posterior circulation cerebral infarction and is closely related to the degree of nerve injury and the change of plaque property.