急性脑梗死患者CT灌注血脑屏障渗透性参数与脑梗死严重程度的关系

Relationship between permeability parameters of blood-brain barrier(BBB)and severity of cerebral infarction after CT perfusion in patients with acute cerebral infarction

目的探讨急性脑梗死患者电子计算机断层扫描(CT)灌注血脑屏障渗透性参数与脑梗死严重程度的关系。方法选取2022年4月-2024年4月在本院治疗的40例急性脑梗死患者作为观察组;同时选取本院同期住院患者非急性脑梗死患者40例为对照组。两组受试者均使用64排螺旋CT机进行扫描,分析得到CT灌注血脑屏障渗透性参数[脑血流图(CBF)、脑血容量图(CBV)、局部灌注达峰时间(TTP)、相对脑血流(rCBF)、相对脑血容量(rCBV)、CBF面积、CBV面积及TTP面积]。对比两组CT灌注血脑屏障渗透性参数差异,通过ROC分析CT灌注血脑屏障渗透性参数预测急性脑梗死的价值,对比不同病情严重程度急性脑梗死患者CT灌注血脑屏障渗透性参数差异,利用Spearman系数分析急性脑梗死患者CT灌注血脑屏障渗透性参数与病情严重程度的相关性。结果观察组CT灌注血脑屏障渗透性参数rCBF、rCBV显著低于对照组,CBF面积、CBV面积及TTP面积显著高于对照组,差异有统计学意义(P<0.05);经ROC分析,rCBF、rCBV、CBF面积、CBV面积、TTP面积预测急性脑梗死的曲线下面积分别为0.735、0.802、0.943、0.902、0.893,均P<0.05;不同病情严重程度患者CT灌注血脑屏障渗透性参数rCBF、rCBV对比,轻度组>中度组>重度组,CBF面积、CBV面积及TTP面积对比,轻度组<中度组<重度组,差异有统计学意义(P<0.05);经相关性分析证实,急性脑梗死患者CT灌注血脑屏障渗透性参数rCBF、rCBV与患者病情严重程度呈负相关,CBF面积、CBV面积、TTP面积与患者病情严重程度呈正相关,均P<0.05。结论急性脑梗死患者CT灌注血脑屏障渗透性参数rCBF、rCBV显著低于对照组,CBF面积、CBV面积及TTP面积显著高于对照组,且通过ROC及Spearman系数证实,CT灌注血脑屏障渗透性参数在急性脑梗死的诊断及疾病严重程度评估中具有重要的临床应用价值,值得临床医师关注。

Objective To study the relationship between the permeability parameters of perfusion bloodbrain barrier(BBB)and the severity of cerebral infarction in patients with acute cerebral infarction.Methods Select 40 patients with acute cerebral infarction who were treated in the hospital from April 2022 to April 2024 as observation group.At the same time,40 non acute cerebral infarction patients who were hospitalized in the hospital during the same period were selected as control group.Both groups of subjects were scanned using a 64 row spiral CT machine.The permeability parameters of blood brain barrier after CT perfusion were analyzed[CBF,CBV,TTP,relative CBF(rCBF),relative CBV(rCBV),CBF area,CBV area and TTP area].The permeability parameters of BBB after CT perfusion were compared between the 2 groups,the value of CT perfusion BBB permeability parameters in predicting acute cerebral infarction was analyzed by ROC,the permeability parameters of BBB after CT perfusion in patients with acute cere-bral infarction of different severity were compared.Spearman coefficient was used to analyze the correla-tion between CT perfusion BBB permeability parameters and disease severity in patients with acute cerebral infarction.Results The permeability parameters rCBF and rCBV of CT perfusion BBB in the observation group were significantly lower than those in control group,and the CBF area,CBV area and TTP area in the observation group were significantly higher than those in the control group,with statistical significance(P<0.05).ROC analysis showed that the areas under the curve predicted by rCBF,rCBV,CBF area,CBV area and TTP area were 0.735,0.802,0.943,0.902 and 0.893,respectively(P<0.05).The per-meability parameters rCBF and rCBV of CT perfusion BBB in patients with different severity were com-pared,mild group>moderate group>severe group.The comparison of CBF area,CBV area and TTP area showed that mild group<moderate group<severe group,and the difference was statistically significant(P<0.05).Correlation analysis confirmed that the permeability parameters rCBF and rCBV of CT perfusion BBB in patients with acute cerebral infarction were negatively correlated with the severity of the patient's condition,CBF area,CBV area and TTP area were positively correlated with the severity of the patients'disease,with P<0.05.Conclusion The CT perfusion BBB permeability parameters rCBF and rCBV in patients with acute cerebral infarction were significantly lower than those in control group,while the CBF area,CBV area and TTP area were significantly higher than those in control group.The ROC and Spearman coefficients confirmed that CT perfusion BBB permeability parameters have important clinical application value in the diagnosis and disease severity assessment of acute cerebral infarction,and are wor-thy of clinical attention.