CTA联合血清MMP-9、TIMP-1对脑梗死患者颈动脉斑块诊断价值

Diagnostic Value of CTA Combined with Serum MMP-9 and TIMP-1 on Carotid Plaque in Patients with Cerebral Infarction

目的探究计算机断层扫描血管成像(CTA)联合血清基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶组织抑制剂-1(TIMP-1)对脑梗死患者颈动脉斑块诊断价值。方法选取2021年5月-2021年12月期间我院神经内科收治的140例脑梗死患者作为试验组研究对象,另选择同期至我院进行体检的健康者80例作为参照组。试验组患者均行CTA和数字减影血管造影(DSA),分析CTA诊断颈动脉斑块价值。试验组和参照组均接受血清MMF-9 TIMP-1检测。对比试验组与参照组的血清MMP-9、TIMP-1水平差异。在试验组中,以DSA为金标准,将患者分为斑块组和无斑块组,对比两组之间的血清MMP-9、TIMP-1水平差异,对CTA联合血清MMP-9、TIMP-1诊断颈动脉斑块的效果进行受试者特征曲线(ROC)分析。结果CTA检测结果显示存在颈动脉斑块者64例,无斑块组76例,CTA诊断颈动脉斑块敏感度为96.88%,特异性为97.37%,准确度为97.14%;试验组血清MMP-9水平显著高于参照组(P<0.05),TIMP-1水平显著低于参照组(P<0.05);斑块组血清MMP-9水平显著高于无斑块组(P<0.05),TIMP-1水平显著低于无斑块组(P<0.05);ROC曲线显示血清CTA、MMP-9、TIMP-1水平单独及联合诊断颈动脉斑块AUC值依次为0.979、0.835、0.812和0.993。结论CTA联合血清MMP-9、TIMP-1对脑梗死患者颈动脉斑块具有良好的诊断价值。

Objective To explore the diagnostic value of computed tomography angiography(CTA)combined with serum matrix metalloproteinase-9(MMP-9)and tissue inhibitor of metalloproteinase-1(TIMP-1)on carotid plaque in patients with cerebral infarction.Methods140 patients with cerebral infarction admitted to department of neurology of our hospital from May 2021 to December 2021 were enrolled as experimental group,and 80 healthy people who underwent physical examination in our hospital during the same period were included in reference group.The patients in experimental group underwent CTA and digital subtraction angiography(DSA),and the value of CTA in the diagnosis of carotid plaque was analyzed.The experimental group and the reference group received serum MMP-9 detection and TIMP-1 detection.The differences in serum MMP-9 and TIMP-1 levels were compared between experimental group and reference group.In experimental group,DSA was used as the gold standard,and the patients were divided into plaque group and non-plaque group,and the differences in serum MMP-9 and TIMP-1 levels were compared.The effect of CTA combined with serum MMP-9 and TIMP-1 in the diagnosis of carotid plaque was analyzed by receiver operating characteristic curve(ROC).ResultsCTA detection result showed that there were 64 cases of carotid plaque and 76 cases in non-plaque group.The sensitivity,specificity and accuracy of CTA in the diagnosis of carotid plaque were 96.88%,97.37%and 97.14%.The level of serum MMP-9 in experimental group was significantly higher than that in reference group(P<0.05)while the level of TIMP-1 was significantly lower than that in reference group(P<0.05).Serum MMP-9 level in plaque group was significantly higher(P<0.05)while TIMP-1 level was significantly lower than that in non-plaque group(P<0.05).ROC curve showed that the AUC values of serum CTA,MMP-9 and TIMP-1 levels alone and in combination in the diagnosis of carotid plaque were 0.979,0.835,0.812 and 0.993 respectively.ConclusionCTA combined with serum MMP-9 and TIMP-1 has a good diagnostic value on carotid plaque in patients with cerebral infarction.