MRI斑块参数联合血清D-D对缺血性脑卒中预后预测价值及临床意义

Predictive Value and Clinical Significance of MRI Plaque Parameters Combined with Serum D-D on the Prognosis of Ischemic Stroke

目的 探究磁共振成像(MRI)斑块参数联合血清D-二聚体(D-D)对缺血性脑卒中(IS)预后预测价值及临床意义。方法 选取我院2018年4月至2020年12月IS患者102例,随访90 d,根据预后分为预后良好组[84例,改良RANKIN量表(m RS)≤2分]与预后不良组(18例,m RS评分>2分)。比较两组MRI斑块参数(纤维帽厚度、脂核面积、斑块面积、脂核/斑块面积)、血清D-D水平、NIHSS评分,分析MRI斑块参数、血清D-D与NIHSS、GCS评分相关性,并探讨IS预后影响因素,评价MRI斑块参数、血清D-D对预后预测价值。结果 预后不良组纤维帽厚度低于预后良好组,脂核面积、斑块面积、脂核/斑块面积、血清D-D、NIHSS评分高于预后良好组(P<0.05);Pearsaon相关性分析,纤维帽厚度与NIHSS、GCS评分呈负相关,脂核面积、斑块面积、脂核/斑块面积、血清D-D与NIHSS评分呈正相关(P<0.05);年龄、发病至入院时间、纤维帽厚度、脂核面积、斑块面积、脂核/斑块面积、血清D-D是IS预后的重要影响因素(P<0.05);ROC曲线显示,纤维帽厚度、脂核面积、斑块面积、脂核/斑块面积、血清D-D联合预测预后的AUC为0.948,高于单独预测。结论 MRI斑块参数联合血清D-D可有效预测IS预后,为临床合理治疗提供一定理论依据。

Objective To To explore the prognostic value and clinical significance of magnetic resonance imaging(MRI) plaque parameters combined with serum D-dimer(D-D) for ischemic stroke(IS). Methods 102 patients April 2018 to December 2020 IS our hospital follow-up 90 d,divided according to the prognosis favorable prognosis group [84 cases,improved RANKIN Scale(mRS) ≤2 sub] group with poor prognosis(18 For example,mRS score> 2 points). Compare the two groups of MRI plaque parameters(fibrous cap thickness,fat nucleus area,plaque area,fat nucleus/plaque area),serum DD level,NIHSS score,and analyze the correlation between MRI plaque parameters,serum DD and NIHSS and GCS scores,And discuss the prognostic factors of IS,and evaluate the prognostic value of MRI plaque parameters and serum DD. Results The thickness of the fiber cap in the poor prognosis group was lower than that in the good prognosis group,and the fat core area,plaque area,fat core/plaque area,serum DD,and NIHSS scores were higher than those in the good prognosis group(P<0.05);Pearsaon correlation analysis,fiber Cap thickness was negatively correlated with NIHSS and GCS scores. Lipid nucleus area,plaque area,lipid nucleus/plaque area,serum DD and NIHSS score were positively correlated(P<0.05);age,time from onset to hospital admission,fibrous cap thickness,Lipid nucleus area,plaque area,lipid nucleus/plaque area,and serum DD are important factors influencing the prognosis of IS(P<0.05);ROC curve shows that the thickness of fibrous cap,lipid nucleus area,plaque area,lipid nucleus/plaque The prognostic AUC of the combination of block area and serum DD was 0.948,which was higher than the single prediction. Conclusion The combination of MRI plaque parameters and serum D-D can effectively predict the prognosis of IS and provide a theoretical basis for reasonable clinical treatment.