| 杜国忠.CT血管成像联合血清软骨寡聚基质蛋白、肿瘤坏死因子α刺激基因-6水平对急性脑梗死患者颈动脉粥样硬化程度的评估价值[J].内科急危重症杂志,2026,32(4):373-377 |
| CT血管成像联合血清软骨寡聚基质蛋白、肿瘤坏死因子α刺激基因-6水平对急性脑梗死患者颈动脉粥样硬化程度的评估价值 |
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| DOI：10.11768/nkjwzzzz.202410301189 |
| 中文关键词: 急性脑梗死 颈动脉粥样硬化 CT血管成像 软骨寡聚基质蛋白 肿瘤坏死因子α刺激基因-6 |
| 英文关键词: Acute cerebral infarction Carotid atherosclerosis Computed tomography angiography Cartilage oligomeric matrix protein Tumor necrosis factor α stimulated gene 6 |
| 基金项目:2021年度镇江市社会发展指导性科技计划项目（FZ2021021） |
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| 中文摘要: |
| 摘要 目的：探讨CT血管成像联合血清软骨寡聚基质蛋白（COMP）、肿瘤坏死因子α刺激基因-6（TSG-6）水平评估急性脑梗死患者颈动脉粥样硬化程度的价值。方法：收集186例急性脑梗死颈动脉粥样硬化患者的临床资料，根据数字减影血管造影结果，分为重度硬化组（管径缩窄＞70%或局限性血流信号消失）38例，非重度硬化组（管径缩窄≤70%）148例。采用酶联免疫吸附法检测血清COMP、TSG-6水平；以受试者工作特征（ROC）曲线分析各指标对急性脑梗死患者重度颈动脉粥样硬化的诊断价值；采用Kappa检验评估各指标与数字减影血管造影结果的一致性。结果：重度硬化组血清COMP、TSG-6水平高于非重度硬化组（P均＜0.05）。血清COMP、TSG-6诊断急性脑梗死患者重度颈动脉粥样硬化的曲线下面积（AUC）分别为0.847（95%CI: 0.772-0.921）、0.849（95%CI: 0.780-0.917）。CT血管成像与数字减影血管造影结果的一致性Kappa值为0.731（P＜0.05）。CT血管成像联合血清COMP、TSG-6与数字减影血管造影结果的一致性Kappa值为0.885（P＜0.05）。CT血管成像与血清COMP、TSG-6三者联合的诊断特异性、准确度、阳性预测值高于各指标单独诊断，误诊率低于各指标单独诊断，阴性预测值高于血清COMP、TSG-6单独诊断，灵敏度高于血清COMP单独诊断，漏诊率低于血清COMP单独诊断（P均＜0.05）。结论：CT血管成像联合血清COMP、TSG-6对急性脑梗死患者重度颈动脉粥样硬化的诊断价值较高。 |
| 英文摘要: |
| Abstract Objective: To explore the value of computed tomography (CT) angiography combined with serum cartilage oligomeric matrix protein (COMP) and tumor necrosis factor α stimulated gene-6 (TSG-6) levels in evaluating the degree of carotid atherosclerosis in patients with acute cerebral infarction. Methods: The clinical data, digital subtraction angiography results and CT angiography results of 186 patients with acute cerebral infarction and carotid atherosclerosis were gathered and separated into 38 cases of severe sclerosis group and 148 cases of non-severe sclerosis group. ELISA method was applied to detect serum levels of COMP and TSG-6. Receiver operating characteristic (ROC) curve was applied to analyze the diagnostic value of each method for severe carotid atherosclerosis in patients with acute cerebral infarction. Kappa test was applied to evaluate the consistency between diagnostic indicators and digital subtraction angiography results. Results: The serum levels of COMP and TSG-6 in the severe sclerosis group were higher than those in the non-severe sclerosis group (P < 0.05). The area under the cure (AUC) of serum COMP and TSG-6 diagnosis for severe carotid atherosclerosis in patients with acute cerebral infarction was 0.847 (95%CI: 0.772-0.921), 0.849 (95%CI: 0.780-0.917), respectively. The Kappa value of consistency between CT angiography and digital subtraction angiography results was 0.731 (P< 0.05). The Kappa value of consistency between CT angiography combined with serum COMP, TSG-6 and digital subtraction angiography results was 0.885 (P< 0.05). The diagnostic specificity, accuracy, and positive predictive value of CT angiography combined with serum COMP and TSG-6 were higher than those of individual diagnosis indicators, and the misdiagnosis rate was lower than that of individual diagnosis indicators. The negative predictive value was higher than that of individual diagnoses of serum COMP and TSG-6, and the sensitivity was higher than that of individual diagnosis of serum COMP. The missed diagnosis rate was lower than that of individual diagnosis of serum COMP (P< 0.05). Conclusion: CT angiography combined with serum COMP and TSG-6 has high diagnostic value for severe carotid atherosclerosis in patients with acute cerebral infarction. |
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