CT灌注成像参数对脑梗死患者溶栓治疗效果的预测价值

Prognostic value of CT perfusion parameters for thrombolysis in patients with cerebral infarction

目的探讨CT灌注成像(CTP)参数对脑梗死(CI)患者溶栓治疗效果的预测价值。方法选取2021年1月~2023年1月在医院接受溶栓治疗的CI患者100例,评估所有患者治疗效果,根据结果分为不佳组与良好组,设计基线资料调查表,详细统计两组基线资料及CTP参数并比较,重点分析CTP参数对CI患者溶栓治疗效果的预测价值。结果经评估,100例CI患者经溶栓治疗后,效果良好有68例,占比68.00%,效果不佳有32例,占比32.00%;不佳组血流量(CBF)及脑血容量(CBV)低于良好组,达峰时间(TTP)及脑平均通过时间(MTT)高于良好组(P<0.05);绘制ROC曲线结果显示,CTP参数预测CI患者溶栓治疗效果的AUC均>0.70,预测价值理想,且以联合预测价值最佳。结论根据CTP中CBV、CBF、MTT、TTP参数可预测CI患者溶栓治疗效果,CBV、CBF低表达、MTT、TTP过表达提示溶栓治疗效果不佳风险高。

Objective To investigate the predictive value of CT perfusion imaging(CTP)parameters for thrombolysis in patients with cerebral infarction(CI).Methods 100 patients with CI who received thrombolytic therapy in hospital from January 2021 to January 2023 were selected to evaluate the therapeutic effect of all patients,and were divided into poor group and good group according to the results.The baseline data questionnaire was designed,and the baseline data and CTP parameters of the two groups were analyzed in detail and compared,focusing on the prediction value of CTP parameters on the therapeutic effect of thrombolytic therapy in CI patients.Results After thrombolysis in 100 CI patients,68 cases(68.00%)had good results and 32 cases(32.00%)had poor results.Blood flow(CBF)and cerebral blood volume(CBV)in poor group were lower than those in good group,peak time(TTP)and mean brain transit time(MTT)were higher than those in good group,with statistical difference(P<0.05).The ROC curve showed that the AUC of CTP parameter in predicting the efficacy of thrombolytic therapy in CI patients was all>0.70,and the predictive value was ideal,and the combined predictive value was the best.Conclusion Parameters of CBV,CBF,MTT and TTP in CTP can predict the efficacy of thrombolytic therapy in CI patients.Low expression of CBV and CBF and over expression of MTT and TTP suggest a high risk of poor efficacy of thrombolytic therapy.