CT灌注成像参数联合ABCD2评分预测TIA患者短期脑卒中发生风险的价值

The Value of CT Perfusion Imaging Parameters Combined with ABCD2 Score in Predicting Short-term Stroke Risk in TIA Patients

【目的】探讨CT灌注成像(CTP)参数联合ABCD2评分预测短暂性脑缺血发作(TIA)患者短期内发生脑卒中的价值。【方法】91例TIA患者,根据入院7 d后是否发生脑卒中将其分为脑卒中组(n=33)与非脑卒中组(n=58)。比较两组患者一般资料、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血栓调节蛋白(TM)、D-二聚体(D-D)、空腹血糖、ABCD2评分及CTP参数[脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)以及达峰时间(TTP)]水平,通过受试者工作特征(ROC)曲线分析相关指标预测TIA患者短期内发生脑卒中的价值,采用多因素Logistic回归分析TIA患者短期内发生脑卒中的危险因素。【结果】两组性别、年龄、合并症、体重指数(BMI)、饮酒史、LDL-C、HDL-C、CBV、空腹血糖比较,差异均无统计学意义(P>0.05);脑卒中组TM、D-D、TTP、MTT、ABCD2评分均显著高于非脑卒中组,CBF显著低于非脑卒中组(P<0.05);经ROC分析,TM≥28.918 g/L、D-D≥487.548 mg/L、TTP≥15.297 s、MTT≥4.340 s、ABCD2评分≥4.632分、CBF≤28.313 mL/(100 g·min)是预测TIA患者短期内发生脑卒中的最佳截断值(均P<0.05);Logistic回归分析显示上述指标是TIA患者短期内发生脑卒中的危险因素(P<0.05)。【结论】TIA患者短期内发生脑卒中与TM、D-D、TTP、MTT、CBF、ABCD2评分显著有关,应对其密切监测。

【Objective】To investigate the value of CT perfusion imaging(CTP)parameters combined with ABCD2 score in predicting stroke in patients with transient ischemic attack(TIA).【Methods】A total of 91 TIA patients were divided into stroke group(n=33)and non stroke group(n=58)according to whether stroke occurred 7 days after admission.The general data,low-density cholesterol(LDL-C),high-density cholesterol(HDL-C),thrombomodulin(TM),D-dimer(D-D),fasting blood glucose,ABCD2 score and CTP parameters cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT)and time to peak(TTP)of the two groups were compared.The value of short-term stroke in TIA patients was predicted by analyzing the relevant indicators of the reciever's oprating characteristic curve(ROC),and the risk factors of short-term stroke in TIA patients were identified by multivariate logistic regression analysis.【Results】There was no significant difference in sex,age,comorbidity,body mass index(BMI),drinking history,LDL-C,HDL-C,CBV and fasting blood glucose between the two groups(P>0.05);The scores of TM,D-D,TTP,MTT and ABCD2 in stroke group were significantly higher than those in non stroke group,and the CBF was significantly lower than that in non stroke group(P<0.05);ROC analysis showed that TM≥28.918 g/L,D-D≥487.548 mg/L,TTP≥15.297 s,MTT≥4.340 s,ABCD2 score≥4.632,CBF≤28.313 mL/(100 g·min)were the best cutoff values for predicting stroke in TIA patients in the short term(all P<0.05);Logistic regression analysis showed that the above indicators and data were risk factors for stroke in TIA patients in the short term(P<0.05).【Conclusion】The occurrence of stroke in TIA patients in the short term is related to TM,D-D,TTP,MTT,CBF,ABCD2 scores,which should be closely monitored.