磁共振成像弥散张量成像参数联合血清NSE、Lp-PLA2在脑梗死患者的诊断和预后不良风险评估中的应用价值

Application Value of Magnetic Resonance Imaging Diffusion Tensor Imaging Parameters Combined with Serum NSE and Lp-PLA2 in the Diagnosis and Risk Assessment of Poor Prognosis of Patients with Cerebral Infarction

目的:探讨磁共振成像(MRI)弥散张量成像(DTI)参数联合血清神经元特异性烯醇化酶(NSE)、脂蛋白相关磷脂酶A2(Lp-PLA2)在脑梗死患者的诊断和预后不良风险评估中的应用价值。方法:选择2021年3月至2022年9月吉林大学中日联谊医院收治的106例脑梗死患者作为脑梗死组,另选同期62例体检健康志愿者作为对照组,比较两组DTI参数,血清NSE和Lp-PLA2水平。脑梗死组出院90d后,采用改良Rankin量表(m RS)进行预后评估,分为预后良好组与预后不良组,并比较两组上述指标水平。受试者工作特征(ROC)曲线分析DTI参数联合血清NSE、Lp-PLA2诊断脑梗死和预测脑梗死患者预后的价值。结果:脑梗死组表观弥散系数(ADC)值、部分各向异性指数(FA)值低于对照组(P<0.05),血清NSE、Lp-PLA2水平高于对照组(P<0.05)。预后不良组FA值、ADC值低于预后良好组(P<0.05),血清NSE、Lp-PLA2水平高于预后良好组(P<0.05)。联合FA值、ADC值、NSE和Lp-PLA2诊断脑梗死以及预测脑梗死患者预后不良的曲线下面积(AUC)分别为0.852、0.874,均高于各因素单独诊断和预测。结论:脑梗死DTI参数FA值、ADC值降低,血清NSE、Lp-PLA2水平增高,联合DTI参数和血清NSE、Lp-PLA2检测在脑梗死诊断和预后预测中具有较高价值。

Objective:To explore the application value of magnetic resonance imaging(MRI)diffusion tensor imaging(DTI)parameters combined with serum neuron specific enolase(NSE)and lipoprotein-associated phospholipase A2(Lp-PLA2)in the diagnosis and risk assessment of poor prognosis of patients with cerebral infarction.Methods:106 patients with cerebral infarction who were admitted to China Japan Friendship Hospital of Jilin University from March 2021 to September 2022 were selected as cerebral infarction group,another 62 healthy volunteers who were underwent physical examinations during the same period were selected as control group,the DTI parameters,serum NSE and Lp-PLA2 levels were compared between two groups.90d after discharge from cerebral infarction group,the assessment of prognosis by the modified Rankin scale(mRS),they were divided into good prognosis group and poor prognosis group,and the above indicators levels were compared between two groups.The value of DTI parameters combined with serum NSE and Lp-PLA2 for diagnosed cerebral infarction and predicted the prognosis of patients with cerebral infarction was analyzed by the receiver operating characteristic(ROC)curve.Results:The apparent diffusion coefficient(ADC)value and fractional anisotropy index(FA)value of cerebral infarction group were lower than those of control group(P<0.05),and the serum NSE and Lp-PLA2 levels were higher than those of control group(P<0.05).The FA value and ADC value of poor prognosis group were lower than those of good prognosis group(P<0.05),and the serum NSE and Lp-PLA2 levels were higher than those of good prognosis group(P<0.05).The area under the curve(AUC)for diagnosed cerebral infarction and predicted poor prognosis of patients with cerebral infarction by combined with FA value,ADC value,NSE and Lp-PLA2 were 0.852 and 0.874,respectively,and which were higher than individual diagnosed and predicted of each factor.Conclusion:The DTI parameters FA value and ADC value of cerebral infarction decrease,while serum NSE and Lp-PLA2 levels increase,combine with DTI parameters and serum NSE and Lp-PLA2 detection has high value for the diagnosis and prognosis predict of cerebral infarction.