脑CT灌注成像联合血清T3、FT4对早期重型颅脑损伤的诊断价值

Application Value of CT Perfusion Imaging Combined with Serum T3 and FT4 in Diagnosis of Early Severe Traumatic Brain Injury

【目的】探讨脑CT灌注成像(CTPI)联合血清三碘甲状腺原氨酸(T3)、游离甲状腺素(FT4)对早期重型颅脑损伤(sTBI)的诊断价值。【方法】回顾性分析2018年1月至2021年12月本院收治的80例早期sTBI患者的临床资料,根据入院后格拉斯哥昏迷评分(GCS)分别纳入重症组(n=43)、轻中度组(n=37)。两组患者均行脑CTPI检查,比较两组局部脑血流参数及血清T3、FT4水平,比较重症组局部脑血流参数及血清T3、FT4水平及GCS。分析GCS与局部脑血流参数、血清T3、FT4水平的相关性。【结果】重症组局部脑血容积(rCBV)、局部脑血液量(rCBF)及血清T3、FT4水平均低于中症组,MTT高于轻中度组,差异有统计学意义(P<0.05)。术后7d,重症组rCBV、rCBF、GCS评分及血清T3、FT4水平高于入院次日,MTT高于入院次日,差异有统计学意义(P<0.05)。Pearson相关性分析显示:GCS与rCBV及血清T3、FT4水平负相关(r=-0.4003、-0.6841、-0.7136,均P<0.05),与rCBF、MTT无相关性(P>0.05)。【结论】脑CTPI与血清T3、FT4联合诊断早期sTBI有助于评价患者颅脑损伤程度,对提高诊断准确率有重要意义。

【Objective】To explore the value of CT perfusion imaging(CTPI)combined with serum triiodothyronine(T3)and free thyroxine(FT4)in the diagnosis of early severe traumatic brain injury(sTBI).【Methods】The clinical data of 80 patients with early sTBI admitted to our hospital from January 2018 to December 2021 were retrospectively analyzed.According to the Glasgow Coma Scale(GCS)after admission,they were included in the severe group(n=43)and the mild to moderate group(n=37).Cerebral CTPI was performed in both groups to compare the regional cerebral blood flow parameters and serum T3,FT4 levels in the two groups,and the regional cerebral blood flow parameters and serum T3,FT4 levels and GCS in the severe group.The correlation between GCS and regional cerebral blood flow parameters,serum T3 and FT4 levels was analyzed.【Results】The levels of rCBV,rCBF,serum T3 and FT4 in the severe group were lower than those in moderate group,and MTT was higher than that in the mild and moderate group(P<0.05).On the 7th day after operation,the rCBV,rCBF,GCS scores,serum T3 and FT4 levels in the severe group were higher than those on the next day after admission,and the MTT was higher than that on the next day after admission.The difference was statistically significant(P<0.05).Pearson correlation analysis showed that GCS was negatively correlated with rCBV and serum T3 and FT4 levels(r=-0.4003,-0.6841,-0.7136,all P<0.05),but not with rCBF and MTT(P>0.05).【Conclusion】The combination of brain CTPI and serum T3,FT4 in the diagnosis of early sTBI is helpful to evaluate the degree of brain injury and to improve the diagnostic accuracy.