TIA近期进展ACI患者血小板微粒和血清RGMa及CTP参数的变化及意义OACSTPCD
Changes and significance of platelet microparticles,serum RGMa and CTP parameters for recent progression to ACI in patients with TIA
目的 探讨短暂性脑缺血发作(TIA)近期进展急性脑梗死(ACI)患者血小板微粒和血清排斥性导向分子a(RGMa)及CT灌注成像(CTP)参数的变化及意义.方法 选取2020-01-2023-06河北省沧州中西医结合医院收治的TIA患者118例,根据是否发生ACI将患者分为ACI组(35例)及非ACI组(83例).比较2组患者的基线资料、影像学结果、血小板微粒和血清RGMa水平,采用多因素Logistic回归分析TIA患者近期进展ACI的危险因素,采用受试者工作(ROC)曲线分析血小板微粒和RGMa诊断TIA患者近期进展ACI的临床价值.结果 ACI组TIA发作次数、持续时间、血小板微粒计数以及血清RGMa水平均显著高于非ACI组(P<0.05),CBF、CBV均低于非ACI组(P<0.05),MTT、TTP均高于非ACI组(P<0.05).Logistic回归分析显示,发作次数≥3次、持续时间≥60 min、CBF和CBV降低、MTT和TTP升高、血小板微粒计数高以及血清RGMa水平高是TIA患者进展为ACI的危险因素(P<0.05).ROC曲线显示,血小板微粒及血清RGMa对TIA患者近期进展为ACI的最佳截断点分别为8.84×109 个/L、5.22 μg/L,血小板微粒、血清RGMa及联合CTP检查的灵敏度分别为 71.43%、74.29%、80.00%,特异度分别为 91.56%、83.13%、95.18%,准确度分别为85.59%、80.51%、90.68%,AUC分别为0.849、0.825、0.912.结论 TIA患者进展ACI后CBF、CBV降低,MTT、TTP升高,血小板微粒计数及血清RGMa水平显著升高,均对TIA患者进展ACI具有一定的预测价值,血小板微粒计数及血清RGMa联合CTP检测的价值更高.
Objective To investigate the changes and significance of platelet microparticles,serum repulsive directing molecule a(RGMa)and CT perfusion imaging parameters on transient ischemic attack(TIA)in patients with acute cerebral infarction(ACI).Methods A total of 118 patients with TIA admitted to Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2020 to June 23 were selected and were divided into ACI group(35 cases)and non-ACI group(83 cases)according to whether ACI occurred.Baseline data,imaging findings,platelet microparticles and serum RGMa levels were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the recent risk factors for ACI progression in TIA patients.The clinical value of platelet microparticles and RGMa in diagnosing recent progression to ACI in patients with TIA was analyzed using receiver operating characteristic(ROC)curve.Results The frequency,duration,platelet particle count and serum RGMa level of TIA in ACI group were significantly higher than those in non-ACI group(P<0.05),CBF and CBV in ACI group were lower than those in non-ACI group(P<0.05),MTT and TTP were higher than those in non-ACI group(P<0.05).Regression results showed that the number of attacks≥3 times,duration≥60 min,decreased CBF and CBV,increased MTT and TTP,high platelet particle count and high serum RGMa level were risk factors for the progression of ACI in TIA patients(P<0.05).ROC results showed that the best cut-off points of platelet microparticles and serum RGMa for recent progression to ACI in TIA patients were 8.84×109/L and 5.22 μg/L,respectively.The sensitivity of platelet microparticles,serum RGMa and CTP detection were 71.43%,74.29%and 80.00%,respectively.The specificity was 91.56%,83.13%,95.18%,the accuracy was 85.59%,80.51%,90.68%,and the AUC was 0.849,0.825,0.912,respectively.Conclusion After TIA patients progressed to ACI,CBF and CBV decrease,while MTT and TTP increase,platelet microcount and serum RGMa levels significantly increase,both of them have certain predictive value for TIA patients to progress to ACI,but the combined detection value is higher.
李腾;付厚秀;韩荣坤
河北省沧州中西医结合医院,河北 沧州 061000
临床医学
短暂性脑缺血发作急性脑梗死血小板微粒排斥性导向分子aCT灌注成像危险因素预测价值
Transient cerebral ischemiaAcute cerebral infarctionPlatelet microparticlesRepulsive guide molecule aCT perfusion imagingRisk factorsPredictive value
《中国实用神经疾病杂志》 2024 (007)
831-836 / 6
河北省中医药管理局支撑基金项目(编号:2022248)
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