临床神经外科杂志2026，Vol.23Issue(4)：373-379,7.DOI:10.3969/j.issn.1672-7770.2026.04.003
颅脑双源CTP参数联合血清P2X7R、NRG-1对重度急性脑梗死病情的诊断价值
Diagnostic value of combining dual-source computed tomography perfusion parameters of the brain with serum P2X7R and NRG-1 for severe acute cerebral infarction
摘要
Abstract
Objective To explore the diagnostic value of dual source computed tomography perfusion(CTP)combined with serum purinergic 2X7R receptor(P2X7R)and neuregulin-1(NRG-1)for the severity of acute cerebral infarction(ACI).Methods One hundred and sixty-five ACI patients admitted to Fengfeng General Hospital,North China Medical Health Group from January 2023 to March 2025 were selected as the observation group.National Institute of Health stroke scale(NIHSS)scores,ACI patients were assigned into mild ACI group(n=61),moderate ACI group(n=54),and severe ACI group(n=50).Meanwhile,another 165 healthy individuals who underwent physical check-ups were considered as the control group(NC group).All ACI patients underwent dual-source CTP examination of the brain within 24 hours of onset to obtain cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),and time to peak(TTP).Fasting venous blood was collected on the second day after admission,and serum P2X7R and NRG-1 were detected by ELISA.The clinical data and laboratory indicators of each group were compared.Multivariate logistic regression analysis was conducted to investigate the influencing factors of severe ACI.ROC curve was used to evaluate the diagnostic performance of each indicator and the combined model for severe ACI.Results Compared with the NC group,the ACI group had prominently higher serum P2X7R and NRG-1(P<0.05).The proportion of smoking history,TTP,MTT,P2X7R,and NRG-1 sequentially prominently increased in the mild ACI group,moderate ACI group,and severe ACI group,while CBF and CBV sequentially prominently decreased(P<0.05).High CBF and CBV were independent protective factors affecting the severity of ACI,while high TTP,MTT,P2X7R,and NRG-1 were independent risk factors(P<0.05).The area under curve(AUC)for the individual diagnosis of severe ACI based on CBF,CBV,TTP,MTT,P2X7R,and NRG-1 levels was 0.807,0.809,0.819,0.785,0.844,and 0.823,respectively.The AUC for combined diagnosis was 0.951,which was superior to individual diagnosis(ZCBF-combination=4.124,ZCBV-combination=4.063,ZTTP-combination=3.253,ZMTT-combination=3.311,ZP2X7R-combination=2.902,ZNRG-1-combination=2.951,all P<0.05).Conclusions The levels of serum P2X7R and NRG-1,as well as the quantitative parameters of dual-source CTP,are closely related to the severity of ACI.The combination of the two can significantly enhance the diagnostic efficacy for severe ACI and holds significant clinical application value.关键词
双源 CT 灌注成像/急性脑梗死/嘌呤能2X7 受体/神经调节蛋白-1/诊断价值Key words
dual source computed tomography perfusion/acute cerebral infarction/purinergic 2X7 receptor/neuregulin-1/diagnostic value分类
医药卫生引用本文复制引用
于欣欣,李珑,王雪皎,王超,申真,赵姗姗..颅脑双源CTP参数联合血清P2X7R、NRG-1对重度急性脑梗死病情的诊断价值[J].临床神经外科杂志,2026,23(4):373-379,7.基金项目
邯郸市科学技术研究与发展计划项目(23422083383) （23422083383）
