CT血管造影联合血清脂蛋白磷脂酶A2对急性缺血性脑血管疾病患者的临床应用价值

Clinical value of CT angiography(CTA)combined with serum lipoprotein phospholipase A2 in patients with acute ischemic cerebrovascular disease

目的研究CT血管造影(CT angiography,CTA)联合血清脂蛋白磷脂酶A2(Lipoprotein-associated phospholipase A2,Lp-PLA2)在急性缺血性脑血管疾病诊断中的临床应用价值。方法选取2021年4月-2022年4月中国人民解放军联勤保障部队第九一O医院神经内科收治的121例急性脑血管病患者为患病组,另取同时期121例健康体检者为对照组,采用酶联免疫吸附试验检测2组血清Lp-PLA2水平。对急性脑血管病患者进行CTA检查,以数字减影血管造影(Digital subtraction angiography,DSA)检查为金标准,评估CTA检查的准确度、敏感度及特异度,分析CTA联合Lp-PLA2检查的准确度、敏感度及特异度。结果与对照组比较,患病组Lp-PLA2水平升高,差异有统计学意义(P<0.05)。DSA检查结果阳性率为79%,CTA检查结果阳性率为74%,CTA联合Lp-PLA2检查结果阳性率为81%,且二者与DSA检测结果一致性较好(P均<0.001)。CTA联合Lp-PLA2诊断的准确度、灵敏度均高于CTA单独诊断(P均<0.05)。结论Lp-PLA2辅助CTA对诊断急性缺血性脑血管疾病有重要的诊断价值。

Objective The objective of this study was to investigate the clinical value of CT angiography(CTA)combined with serum Lipoprotein-associated phospholipase A2(Lp-PLA2)in the diagnosis of acute ischemic cerebrovascular diseases.Methods 121 patients with acute cerebrovascular diseases admitted to the hospital from April 2021 to April 2022 were selected as the disease group,while another 121 healthy individuals undergoing physical examinations during the same period were selected as the control group,and the serum Lp-PLA2 level of the two groups were detected by enzyme-linked immunosorbent assay.For patients with acute cerebrovascular disease and digital subtraction angiography(DSA)were used as the gold standard for CTA examination to evaluate the accuracy,sensitivity and specificity of CTA examination,and to analyze the accuracy of CTA combined with Lp-PLA2 examination,sensitivity and specificity.Results Compared to the control group,the disease group exhibited significantly higher levels of Lp-PLA2,with statistically significant differences(P<0.05).The positive rate of DSA test results was 79%,and the positive rate of CTA test results was 74%.The positive rate of CTA combined with Lp-PLA2 test result was 81%,and the two were in good agreement with DSA test results(P all<0.001).The diagnostic accuracy and sensitivity of CTA combined with Lp-PLA2 were higher than those of CTA alone(P all<0.05).Conclusion Lp-PLA2 assisted CTA has important diagnostic value in the diagnosis of acute ischemic cerebrovascular diseases.