摘要
目的:探讨早期大面积脑梗死患者视神经鞘直径(ONDS)和眼球横向直径(ETD)的比值在预测恶性脑梗死发生中的价值。方法:回顾性分析2016年7月-2019年9月在福建医科大学附属龙岩第一医院神经内科住院80例大面积脑梗死患者,根据是否发生恶性脑梗死分为恶性脑梗死组(46例)和非恶性脑梗死组(34例);所有病例均在脑梗死发病后12~48 h行头颅和眼眶部进行薄层CT扫描,并利用电子卡尺进行ONSD及ETD值的测定,并计算ONSD/ETD比值;构建受试者工作特征(ROC)曲线,用受试者工作特征曲线下面积(AUC)评价ONSD/ETD对恶性脑梗死发生的预测价值,并计算ONSD/ETD的敏感度、特异度。结果:恶性脑梗死组ONSD、ETD平均值分别为(5.60±0.37)、(22.20±0.80)mm,ONSD/ETD比值为(0.25±0.02);非恶性脑梗死组ONSD、ETD平均值分别为(5.23±0.18)、(22.28±0.95)mm,ONSD/ETD比值为(0.24±0.01);恶性脑梗死组ONSD/ETD比值与非恶性脑梗死组比较差异有统计学意义(P<0.05)。ONSD/ETD预测恶性脑梗死发生的ROC曲线下面积为0.81(95%CI:0.71,0.91),当ONSD/ETD=0.25时,灵敏度为60.1%,特异度为100%。结论:ONSD/ETD比值对早期大面积脑梗死患者预测恶性脑梗死发生中有重要的临床价值。
Objective:To investigate the diagnostic value of the ratio of optic nerve sheath diameter to eyeball transverse diameter in predicting the occurrence of malignant cerebral infarction in patients with early massive cerebral infarction.Method:A retrospective analysis of 80 patients with massive cerebral infarction in the Department of Neurology,Longyan First Hospital Affiliated to Fujian Medical University from July 2016 to September 2019.According to the occurrence of malignant cerebral infarction,the patients were divided into malignant cerebral infarction group(46 cases)and non malignant cerebral infarction group(34 cases).Thin slice CT scan of head and orbit was performed 12-48 hours after the onset of cerebral infarction in all cases,the ONSD and ETD values were measured by electronic caliper,and the ONSD ETD ratio was calculated.Structure receiver operator characteristics curves(ROC).The prediction value of ONSD/ETD on the occurrence of malignant cerebral infarction was evaluated by the area under the curve(AUC),the sensitivity and specificity of ONSD/ETD were calculated.Result:The mean values of ONSD and ETD in patients with malignant cerebral infarction were(5.60±0.37)mm and(22.20±0.80)mm,respectively,and ONSD/ETD ratio is(0.25±0.02).The mean values of ONSD and ETD in non malignant cerebral infarction patients were(5.23±0.18)mm and(22.28±0.95)mm,respectively,and the ratio of ONSD/ETD was(0.24±0.01).There was significant difference between the ratio of ONSD/ETD in malignant cerebral infarction group and non malignant cerebral infarction group(P<0.05).Prediction of the area under ROC curve of malignant cerebral infarction by ONSD/ETD was 0.81(95%CI:0.71,0.91).When ONSD/ETD=0.25,the sensitivity was 60.1%,and the specificity was 100%.Conclusion:ONSD/ETD ratio has important clinical value in predicting the occurrence of malignant cerebral infarction in patients with early massive cerebral infarction.
作者
沈超雄
吴婷玉
傅华俊
胡职舟
胡小红
SHEN Chaoxiong;WU Tingyu;FU Huajun;HU Zhizhou;HU Xiaohong(Longyan First Hospital Affiliated to Fujian Medical University,Longyan 364000,China)
出处
《中外医学研究》
2020年第33期154-156,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
大面积脑梗死
视神经鞘直径
眼球横向直径
恶性脑梗死
Massive cerebral infarction
Optic nerve sheath diameter
Eyeball transverse diameter
Malignant cerebral infarction
