摘要
目的探讨经颅彩色多普勒超声(TCCD)参数与血清胰岛素样生长因子-1(IGF-1)、神经元特异性烯醇化酶(NSE)检测在脑梗死病情评估中的应用价值及意义。方法选取2018年4月至2020年2月安徽皖北煤电集团总医院收治的脑梗死患者110例,入院后均实施TCCD检查,抽取血液样本测定血清IGF-1、NSE水平,并给予对应治疗。比较不同病情程度、斑块性质及随访3个月不同预后患者TCCD参数与血清IGF-1和NSE水平,分析上述指标与病情、斑块性质的相关性及对脑梗死患者预后的预测价值。结果IGF-1水平与病情程度(r=-0.650)、斑块性质(r=-0.711)存在负相关关系(P<0.05),NSE水平及阻力指数(RI)、搏动指数(PI)与病情程度(r=0.609、0.613、0.645)、斑块性质(r=0.589、0.579、0.608)存在正相关关系(P<0.05)。随访3个月,预后良好94例,预后不良16例。预后良好者IGF-1水平高于预后不良者[(101.05±12.89)μg/L比(66.92±14.14)μg/L],NSE水平及RI、PI低于预后不良者[(9.01±2.64)μg/L比(25.13±3.82)μg/L、1.05±0.19比1.32±0.22、0.69±0.06比0.89±0.07],差异均有统计学意义(P<0.05)。RI、PI、IGF-1和NSE预测脑梗死预后的曲线下面积(AUC)均小于联合诊断。结论早期采用TCCD参数、血清IGF-1和NSE水平共同检测,可为评估脑梗死患者病情及预后提供指导。
Objective To explore the value and significance of transcranial color-coded duplex(TCCD)parameters,serum insulin-like growth factor-1(IGF-1),neuron-specific enolase(NSE)levels in the evaluation of the condition of cerebral infarction.Methods One hundred and ten patients with cerebral infarction in Anhui Wanbei Coal-Electricity Group General Hosptial were selected from April 2018 to February 2020,and TCCD examination was performed after admission.Blood samples were taken to determine the levels of serum IGF-1 and NSE,and corresponding treatment was given.The TCCD parameters and serum IGF-1 and NSE levels were compared in patients with different disease severity,plaque nature and different prognosis after 3 months′follow-up.The correlation between the above indicators and the condition and plaque nature and the predictive value of the prognosis of patients with cerebral infarction were analyzed.Results The level of IGF-1 were negatively correlated with the severity of disease(r=-0.650)and the nature of plaques(r=-0.711);and the level of NSE and resistance index(RI),pulsatility index(PI)were positively correlated with the severity of the disease(r=0.609,0.613,0.645)and the nature of plaques(r=0.589,0.579,0.608),and the differences were statistically significant(P<0.05).After 3 months′follow-up,the level of IGF-1 in the favourable prognosispatients was higher than that in the unfavourable prognosis patients,the levels of NSE,RI and PI in the favourable prognosis patients were lower than those in the unfavourable prognosis patients:(9.01±2.64)μg/L vs.(25.13±3.82)μg/L,1.05±0.19 vs.1.32±0.22,0.69±0.06 vs.0.89±0.07,and the differences were statistically significant(P<0.05).The area under the curve(AUC)of RI,PI,IGF-1 and NSE in predicting the prognosis of cerebral infarction was less than that of combined diagnosis.Conclusions The early use of TCCD parameters,serum IGF-1 and NSE combined detection can provide evidence-based guidance for evaluating the condition and prognosis of cerebral infarction.
作者
朱军
李振鹏
方开峰
Zhu Jun;Li Zhenpeng;Fang Kaifeng(Department of Ultrasound,Anhui Wanbei Coal-Electricity Group General Hosptial,Anhui Suzhou 234000,China;Department of Medical Laboratory,Anhui Wanbei Coal-Electricity Group General Hosptial,Anhui Suzhou 234000,China)
出处
《中国医师进修杂志》
2021年第4期367-371,共5页
Chinese Journal of Postgraduates of Medicine
基金
蚌埠医学院自然科学类项目(BYKY2019248ZD)。
