HR-MRI联合血清PAR-2和PAGln水平对急性脑梗死患者复发的预测价值

Predictive value of HR-MRI combined with serum PAR-2 and PAGln detection for recurrence in patients with acute cerebral infarction

目的探讨高分辨率MRI(HR-MRI)联合血清蛋白酶激活受体2(PAR-2)和苯乙酰谷氨酰胺(PAGln)检测对急性脑梗死(ACI)患者复发的预测价值。方法收集127例ACI患者的临床资料,根据患者出院1年内是否复发将其分为复发组34例和未复发组93例。采用ELISA法测定血清PAR-2和PAGln水平,HR-MRI测定斑块面积、斑块负荷、管腔狭窄率、重构指数和标准化管壁指数,多因素logistic回归分析影响ACI患者复发的因素,ROC曲线分析HR-MRI联合血清PAR-2和PAGln水平对ACI患者复发的预测效能。结果与未复发组相比,复发组患者血清PAR-2和PAGln水平、斑块负荷、管腔狭窄率升高(P<0.05)。血清PAR-2和PAGln水平较高以及斑块负荷较高是ACI患者复发的独立危险因素(P<0.05)。血清PAR-2、PAGln水平和斑块负荷单独预测ACI患者复发的AUC分别为0.852、0.860和0.785,联合预测的AUC为0.941,高于单独预测(P<0.05)。结论ACI复发患者血清PAR-2和PAGln水平升高,HR-MRI联合血清PAR-2和PAGln水平可以更好地预测ACI患者复发。

Objective To explore the predictive value of high-resolution MRI(HR-MRI)combined with serum protease activated receptor 2(PAR-2)and phenylacetyl L-glutamine(PAGln)levels for the recurrence of the patients with acute cerebral infarction(ACI).Methods The clinical data of 127 patients with ACI were collected.According to whether the patients relapsed within 1 year after discharge,the patients were divided into two groups of A(with ACI recurrence,34 cases)and B(without ACI recurrence,93 cases).Serum PAR-2 and PAGln levels were measured by ELISA.HR-MRI was used to measure plaque area,plaque load,lumen stenosis rate,remodeling index and standardized wall index.The influencing factors for the recurrence of ACI were analyzed by multivariate logistic regression analysis.ROC curve analysis was conducted to analyze the predictive efficacy of HR-MRI combined with serum PAR-2 and PAGln levels for the recurrence of ACI patients.Results Serum levels of PAR-2 and PAGln,plaque load and lumen stenosis rate were higher in group A than those in group B(P<0.05).Higher serum PAR-2 and PAGln levels and higher plaque load were the independent risk factors for the recurrence of ACI patients(P<0.05).The AUC values of serum PAR-2,PAGln levels and plaque load for predicting ACI recurrence were 0.852,0.860 and 0.785,respectively.The AUC of combind use of serum PAR-2,PAGln levels and plaque load was 0.941,which was higher than that by any one of them(P<0.05).Conclusion Serum PAR-2 and PAGln levels are increased in ACI patients with recurrence.HR-MRI combined with serum PAR-2 and PAGln levels can better predict the recurrence of ACI patients.