摘要
目的 探讨高分辨率磁共振颅内血管壁成像(HRMRI-VWI)、磁共振扩散加权成像(DWI)下斑块特征及血小板活化水平与后循环脑梗死预后的相关性。方法 采用回顾性研究方法,选取2020年1月至2022年1月在聊城市第二人民医院治疗的后循环脑梗死预后患者130例,其中预后良好和不良患者56例和74例。比较预后良好组和预后不良组患者临床资料、HRMRI-VWI、DWI参数及血小板活化水平差异。结果 预后不良组患者年龄、梗死灶最大径分别为(66.15±9.21)岁和(5.64±1.00)cm,明显高于预后良好组[(61.03±8.84)岁和(4.52±0.88)cm],差异均有统计学意义(P<0.05)。预后不良患者血管最狭窄处管壁面积(WAMLN)、狭窄率分别为(13.06±1.21) mm2和(58.45±4.45)%,明显高于预后良好组[(11.40±1.14) mm2和(50.03±5.12)%],而血管最狭窄处管腔面积(LAMLN)和相对表观扩散系数(rADC)分别为(9.98±1.03) mm2和(0.72±0.11),明显低于预后良好组[(11.40±1.14) mm2和(0.84±0.13)],差异均有统计学意义(P<0.05)。预后不良组患者血小板膜糖蛋白(GP)Ⅰb、GPⅡb、GPⅢb和血小板活化因子(PAF)分别为(2.60±0.55)×104、(4.24±0.73)×104、(5.80±0.62)×104、(245.50±26.69)pg/mL,明显高于预后良好组[(2.21±0.52)×104、(3.71±0.80)×104、(5.14±0.73)×104、(196.63±22.54) pg/mL],差异均有统计学意义(P<0.05)。Logistic回归分析结果显示:年龄、梗死灶最大径、WAMLN、狭窄率、rADC、PAF是患者预后不良的影响因素(P<0.05)。结论 HRMRI-VWI、DWI参数梗死灶最大径、WAMLN、狭窄率、rADC及血小板活化水平是后循环脑梗死患者预后的影响因素,临床应加以重视。
Objective To investigate the correlation between plaque characteristics and platelet activation level on high-resolution magnetic resonance imaging of intracranial vascular wall(HRMRI-VWI) and diffusion-weighted imaging(DWI) and the prognosis of posterior circulation cerebral infarction. Methods A retrospective study was conducted, 130 patients with prognosis of posterior circulation cerebral infarction treated in Liaocheng Second People’s Hospital from January 2020 to January 2022 were selected, including 56 patients with good prognosis and 74 patients with poor prognosis. The clinical data, HRMRI-VWI, DWI parameters and platelet activation level of patients with good prognosis group and poor prognosis group were compared. Results The age and the maximum diameter of infarct of patients with poor prognosis group were(66.15±9.21) years and(5.64 ±1.00) cm, respectively, which were significantly higher than those with good prognosis group[(61.03±8.84) years old and(4.52±0.88) cm], the differences were statistically significant(P<0.05). The wall area of the narrowest vessel(WAMLN) and stenosis rate in patients with poor prognosis group were(13.06±1.21) mm~2 and(58.45±4.45)%, respectively, which were significantly higher than those in patients with good prognosis group [(11.40±1.14) mm~2 and(50.03±5.12)%], while the lumen area of the narrowest vessel(LAMLN) and relative apparent diffusion coefficient(rADC) were(9.98±1.03) mm~2 and(0.72±0.11), which were significantly lower than those in patients with good prognosis [(11.40±1.14) mm~2 and(0.84±0.13)], the differences were statistically significant(P<0.05). The platelet membrane glycoprotein(GP)ⅠB, GPⅡB, GPⅢB and platelet activating factor(PAF) in patients with poor prognosis group were(2.60±0.55)×10~4,(4.24±0.73)×10~4,(5.80±0.62)×10~4 and(245.50±26.69) pg/mL, which were significantly higher than those in patients with good prognosis group [(2.21±0.52)×10~4,(3.71±0.80)×10~4,(5.14±0.73)×10~4 and(196.63±22.54) pg/mL], the differences were
作者
姜达
郑德先
贺亚龙
JIANG Da;ZHENG De-xian;HE Ya-long(Department of Intervention,Liaocheng Second People's Hospital,Liaocheng Shandong 252600,China;Department of Neurology,Yan'an People's Hospital,Yan'an Shaanxi 716099,China.)
出处
《临床和实验医学杂志》
2022年第24期2675-2679,共5页
Journal of Clinical and Experimental Medicine
基金
山东省医学科研基金项目(编号:2020Y0101320)。
关键词
高分辨率磁共振颅内血管壁成像
磁共振扩散加权成像
血小板活化水平
后循环脑梗死
预后
High resolution magnetic resonance imaging of intracranial vascular wall
Diffusion weighted magnetic resonance imaging
Platelet activation level
Posterior circulation cerebral infarction
prognosis
