CTA结合CTP对单侧大脑中动脉供血区脑梗死患者治疗及康复效果的预测价值

doi:10.20047/j.issn1673-7210.2023.35.03

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摘要目的探讨CT血管成像（CTA）结合CT灌注成像（CTP）对单侧大脑中动脉供血区脑梗死患者治疗及康复效果的预测价值。方法选取2020年1月至2022年10月在江苏省苏州市中西医结合医院治疗的单侧大脑中动脉供血区脑梗死患者89例，所有患者均给予常规治疗，随访至治疗后90 d，分析比较治疗有效（65例）和无效（24例）；预后良好（57例）和不良（32例）患者临床资料、CTA和CTP参数差异。结果治疗有效和无效患者侧支循环、相对脑容量（rCBV）比较，差异有统计学意义（P＜0.05）。侧支循环（不良=1，良好=0）、rCBV及二者联合预测治疗无效的受试者操作特征（ROC）曲线下面积分别为0.780、0.724和0.745（P＜0.05）。预后良好和不良患者侧支循环、rCBV、相对平均通过时间比较，差异有统计学意义（P＜0.05）。侧支循环（不良=1，良好=0）、rCBV及联合预测预后不良的ROC曲线下面积分别为0.836、0.767和0.778（P＜0.05）；相对平均通过时间预测预后不良的ROC曲线下面积为0.620（P＞0.05）。结论 CTA结合CTP对单侧大脑中动脉供血区脑梗死患者治疗效果及预后方面有一定的预测价值，值得进一步研究。

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	常冬梅1 李志伟2▲

关键词 ： CT血管成像, CT灌注成像, 单侧大脑中动脉, 治疗效果, 预后, 预测价值

Abstract：Objective To investigate the predictive value of CT angiography (CTA) combined with CT perfusion imaging (CTP) in the treatment and rehabilitation of patients with unilateral middle cerebral artery infarction. Methods A total of 89 patients with unilateral middle cerebral artery infarction who were treated in Suzhou Integrated Traditional and Western Medicine Hospital from January 2020 to October 2022 were selected, all patients were given routine treatment, follow-up to 90 days after treatment, the clinical data, CTA and CTP parameters of patients with effective (65 cases) and ineffective (24 cases) treatment, good prognosis (57 cases) and bad prognosis (32 cases) were analyzed and compared. Results There were significant differences in collateral circulation and relative cerebral volume (rCBV) between effective and ineffective patients (P＜0.05). The area under receiver operator characteristic(ROC) curves for collateral circulation (poor =1, good =0), rCBV and combined prediction of treatment failure were 0.780, 0.724, and 0.745, respectively (P＜0.05). There were significant differences in collateral circulation, rCBV, and relative mean transmit time between good and bad prognosis patients (P＜0.05). The area under ROC curve of collateral circulation, rCBV and combined prediction of poor prognosis were 0.836, 0.767 and 0.778, respectively (P＜0.05). The area under ROC curve of relative mean transmit time for predicting poor prognosis was 0.620 (P＞0.05). Conclusion CTA combined with CTP has a certain predictive value in the treatment effect and prognosis of patients with unilateral middle cerebral artery infarction, which is worth further study.

Key words： CT angiography CT perfusion imaging Unilateral middle cerebral artery Therapeutic effect Prognosis Predictive value

基金资助:国家自然科学基金资助项目（82170831）。

通讯作者: ▲通讯作者

引用本文:

常冬梅1 李志伟2▲. CTA结合CTP对单侧大脑中动脉供血区脑梗死患者治疗及康复效果的预测价值[J]. 中国医药导报, 2023, 20(35): 14-18.
CHANG Dongmei1 LI Zhiwei2▲. Predictive value of CTA combined with CTP in the treatment and rehabilitation of patients with unilateral middle cerebral artery infarction. 中国医药导报, 2023, 20(35): 14-18.

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https://www.yiyaodaobao.com.cn/CN/10.20047/j.issn1673-7210.2023.35.03 或 https://www.yiyaodaobao.com.cn/CN/Y2023/V20/I35/14