ASL技术在急性缺血性脑卒中药物治疗中的应用

Application effects of ASL technique in treatment of acute ischemic stroke

目的探讨动脉自选标记(arterial spin labeling,ASL)技术在急性缺血性脑卒中(acute ischemic stroke,AIS)药物治疗效果中的预测应用价值。方法连续收集2019年2~8月在神经内科确诊为AIS且在发病期间行ASL检查的患者60例。根据入组患者药物治疗后90 d的mRS评分分为预后良好(mRS≤2)组28例,预后不良(mRS>2)组32例。使用Mann-Whitney U检验分析2组间入院NIHSS评分、年龄、CBF_(1.5)及CBF_(2.5)的差异性,使用χ^(2)检验分析2组入院NIHSS分类和患者性别的差异性,使用接收者操作特征曲线(receiver operating characteristic curve,ROC)对有统计学差异的参数进行预后诊断效能判定。结果2组间的年龄、入院NIHSS分类和性别差异均无统计学意义(P>0.05),预后良好组的CBF_(1.5)及CBF_(2.5)显著高于预后不良组(P<0.05),而入院NIHSS评分显著低于预后不良组(P<0.05),CBF_(1.5)及CBF_(2.5)均可对AIS患者药物治疗的预后做预测诊断(P<0.05),CBF_(2.5)效能最佳(AUC=0.871)。结论ASL技术可以对AIS患者药物治疗后的预后结果进行有效预测,CBF_(2.5)越高,则患者短期预后更好。

Objective To investigate the application effects of arterial spin labeling(ASL)technique in treatment of acute ischemic stroke(AIS).Methods Sixty patients with AIS who were diagnosed and treated in our hospital and underwent urgent ASL examination were enrolled in the study.According to the mRS score of 90d after drug treatment,the patients were divided into good prognosis group(MRS≤2,n=28)and poor prognosis group(MRS>2,n=32).Mann-Whitney U test was used to analyze the differences of NIHSS score,age,CBF 1.5 and CBF 2.5 between two groups.Chi-square test was used to analyze the differences of NIHSS classification and gender between the two groups.Receiver operating characteristic curve(ROC)was used to determine the prognostic diagnostic efficacy of the parameters with statistical differences.Results There were no significant differences in age,NIHSS classification and gender between the two groups(P>0.05).The CBF1.5 and CBF2.5 in good prognosis group were significantly higher than those in poor prognosis group(P<0.05),however,the NIHSS scores on admission were significantly lower than those in poor prognosis group(P<0.05).Both CBF1.5 and CBF2.5 could predict the prognosis of patients with AIS(P<0.05),moreover,CBF2.5 had the best efficacy(AUC=0.871).Conclusion ASL technique can effectively predict the prognosis of patients with AIS after drug treatment,and the higher CBF2.5,the better the short-term prognosis.