摘要
目的 探讨颈动脉超声联合血浆脑啡肽原A(PENK-A)水平检测对缺血性脑卒中(ICS)患者颈动脉狭窄程度的诊断价值。方法 收集2019年1月至2022年1月联勤保障部队解放军第九六〇医院收治的103例ICS患者的临床资料,根据颈动脉狭窄程度将患者分为轻中度狭窄组(n=75)与重度狭窄组(n=28)。所有患者均进行了颈动脉超声检查,并检测了颈动脉血流动力学参数[颈内动脉阻力指数(ICA-RI)、搏动指数(PI)、舒张末期流速(EDV)、收缩期峰值流速(PSV)]。采用酶联免疫吸附测定法(ELISA)测定血浆EPNK-A水平。通过受试者工作特征(ROC)曲线分析颈动脉血流动力学参数、血浆PENK-A单独及联合检测对ICS患者颈动脉狭窄程度的诊断价值。结果 经数字减影血管造影(DSA)检查,103例ICS患者中,轻中度狭窄组75例,重度狭窄组28例。重度狭窄组患者的ICA-RI、PI及血浆PENK-A水平均明显高于轻中度狭窄组患者,EDV、PSV水平均明显低于轻中度狭窄组患者,差异均有统计学意义(P<0.01)。ICA-RI、PI、EDV、PSV与血浆PENK-A联合检测对ICS患者重度颈动脉狭窄的诊断价值最高,曲线下面积(AUC)为0.978,灵敏度为99.2%,特异度为88.0%。结论 颈动脉超声联合血浆PENK-A水平检测对ICS患者颈动脉狭窄程度的诊断价值较高。
Objective To investigate the diagnostic value of carotid ultrasound combined with plasma proenkephalin-A(PENK-A)for the carotid stenosis degree in patients with ischemic stroke(ICS).Method The clinical data of 103 patients with ICS admitted to tthe 960th Hospital of the PLA Joint Logistics Support Force from January 2019 to January 2022 were collected.The patients were divided into low to moderate stenosis group(n=75)and severe stenosis group(n=28)based on the carotid stenosis degree.All patients underwent carotid ultrasound examination and carotid artery blood flow parameters[internal carotid artery resistance index(ICA-RI),pulsation index(PI),end-diastolic velocity (EDV), and peak systolic velocity (PSV)] were measured. The plasma PENK-A level was measured by enzyme linked immunosorbent assay (ELISA). The diagnostic value of individual and combined detection of carotid artery blood flow parameters and plasma PENK-A for the degree of carotid stenosis in ICS patients was analyzed by receiver operator characteristic (ROC) curve. Result According to digital subtraction angiography (DSA) examination, among 103 patients with ICS, there were 75 cases in the mild to moderate stenosis group and 28 cases in the severe stenosis group. Compared with mild and moderate stenosis group, the levels of ICA-RI, PI and plasma PENK-A level of patients in severe stenosis group significantly increased, while the EDV and PSV levels of patients in severe stenosis group significantly decreased, and the differences were statistically significant (P<0.01). The combined detection of ICA-RI, PI, EDV, PSV, and plasma PENK-A has the highest diagnostic value for severe carotid stenosis in ICS patients, and the area under the curve (AUC), sensitivity and specificity were 0.978, 99.2% and 88.0%, respectively. Conclusion Carotid ultrasound combined with plasma PENK-A detection has a high diagnostic value for the carotid stenosis degree in ICS patients.
作者
马艳会
董磊
王小刚
Ma Yanhui;Dong Lei;Wang Xiaogang(Department of Ultrasonic Diagnosis,the 960th Hospital of the PLA Joint Logistics Support Force,Ji'nan 250031,Shandong,China;Department of Neurosurgery,the 960th Hospital of the PLA Joint Logistics Support Force,Ji'nan 250031,Shandong,China)
出处
《血管与腔内血管外科杂志》
2024年第2期200-204,共5页
Journal of Vascular and Endovascular Surgery
基金
国家自然科学基金委员会资助项目(81801191)。
