弥散加权成像阴性脑梗死患者平均红细胞体积变化特征

Changes of mean corpuscular volume in patients with cerebral infarction with negative diffusion-weighted imaging

目的探索弥散加权成像(diffusion weighted image,DWI)阴性脑梗死的发病机制,本研究对DWI阴性脑梗死患者的平均红细胞体积(mean corpuscular volume,MCV)的变化特征展开研究。方法患者被分为两组:(1)DWI阴性组:46例患者;(2)DWI阳性组:59例患者。所有患者在3.0T核磁共振扫描仪上进行常规轴位、冠状位薄层、矢状位薄层DWI检查。记录患者的一般资料、测定患者白细胞、红细胞、血小板、血红蛋白、MCV、红细胞比容、平均血小板体积、血小板压积、平均血小板体积等血细胞分析参数和生化参数,计算血浆渗透压。结果DWI阴性组和DWI阳性组患者的血浆渗透压、二氧化碳结合力、血钙浓度、红细胞比容、平均血小板体积、血小板压积和D二聚体水平比较,差异无统计学意义(P分别=0.290、0.558、0.113、0.090、0.401、0.460、0.510)。与DWI阳性组相比,DWI阴性组患者MCV增大(P=0.009)。经Logistic回归分析发现,平均红细胞体积增大是DWI阴性脑梗死发生的独立影响因素(OR=2.864,95%CI 1.385~5.360,P=0.003)。结论DWI阴性脑梗死患者具有血液MCV增大的特征。

Objective To investigate the characteristics of changes in mean red blood cell volume in patients with DWI-negative cerebral infarction.Methods The patients were divided into two groups:(1)DWI negative group:46 patients.(2)DWI positive group:59 patients.All patients underwent routine axial,coronal,and sagittal thin-section DWI examinations on a 3.0T MRI scanner.The general information of the patients was recorded,and the electrolyte levels,carbon dioxide binding capacity,blood lipids,renal function and coagulation function of the patients were determined.Plasma osmotic pressure was calculated.The patient’s white blood cells,red blood cells,platelets,hemoglobin,mean corpuscular volume(MCV),hematocrit,mean platelet volume,platelet volume,and mean platelet volume were measured.Results There was no significant difference in plasma osmotic pressure,carbon dioxide binding capacity,blood calcium concentration,hematocrit,mean platelet volume,platelet volume and D-dimer level between the DWI-negative group and the DWI-positive group(P values equal to 0.290,0.558,0.113,0.090,0.401,0.460,0.510 respectively).Compared with the DWI-positive group,the mean corpuscular volume of the DWI-negative group increased(P=0.009).Logistic regression analysis showed that the increase in mean red blood cell volume was an independent factor for DWI-negative cerebral infarction(OR=2.864,95%CI 1.385~5.360,P=0.003).Conclusion Patients with negative imaging on DWI sequences are characterized by increased mean corpuscular volume in the blood.