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血管超声联合血清CatS/CysC水平在急性脑卒中患者溶栓疗效评估中的应用

Application of vascular ultrasound combined with serum cats/CysC level in the evaluation of thrombolytic efficacy in patients with acute stroke
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摘要 目的 :探讨血管超声联合血清组织蛋白酶S(CatS)与胱抑素C(CysC)水平评估急性脑卒中患者溶栓疗效的价值。方法 :回顾分析2019年10月~2021年6月神经内科收治的100例急性脑卒中并行溶栓治疗的患者血管超声检查、实验室检测及临床资料。根据溶栓效果将患者分为效果良好组(68例)、效果欠佳组(32例)。比较两组患者经颅彩色多普勒超声(TCCS)参数指标:收缩期峰值流速度(PSV)、舒张末期血流速度(EDV)、平均血流速度(MV),搏动指数(PI);比较颈动脉彩色多普勒超声(CDUS)检查结果 :颈动脉内-中膜厚度(IMT),斑块、血流动力学等情况;比较血清CatS、CysC水平。利用受试者工作特征(ROC)曲线评估TCCS参数指标、CDUS检测结果及CatS、CysC水平对溶栓疗效的预测价值。结果 :TCCS检查发现溶栓后效果良好组PSV、EDV、MV显著高于效果欠佳组,PI显著低于效果欠佳组,且上述比较差异具有统计学意义;CDUS检查溶栓后效果良好组RI、PI显著低于效果欠佳组,且内-中膜增厚、斑块、狭窄、闭塞发生率显著低于效果欠佳组;血清检测:溶栓后效果良好组血清CatS、CysC水平显著低于效果欠佳组;ROC曲线分析:EDV、IMT、RI等七项指标对溶栓效果具有较好预测价值。结论 :TCCS、CDUS检查结果联合血清CatS、CysC水平能有效评估并预测急性脑卒中患者溶栓疗效。 Objective To investigate the value of vascular ultrasound combined with serum cathepsin S(CATS) and cystatin C(CysC) levels in evaluating the thrombolytic efficacy of patients with acute stroke. Methods The vascular ultrasound, laboratory test and clinical data of 100 patients with acute stroke treated with thrombolysis from October 2019 to June 2021 were analyzed retrospectively. According to the thrombolytic effect, the patients were divided into good effect group(68 cases) and poor effect group(32 cases). Transcranial color Doppler ultrasound(Transcranial color-coded sonography, TCCS) parameters were compared between the two groups: Peak systolic flow velocity(PSV), end diastolic blood flow velocity(EDV), mean blood flow velocity(MV), pulsatility index(PI);Compare the results of carotid color Doppler ultrasound(CDUS): Carotid intima-media thickness(IMT), plaque and hemodynamics;The levels of serum cats and CysC were compared. The receiver operating characteristic(ROC) curve was used to evaluate the predictive value of TCCS parameters, CDUS test results, cats and CysC levels on thrombolytic efficacy. Results TCCS parameters: after thrombolysis, PSV、EDV、and MV in the good effect group were significantly higher than those in the poor effect group, and PI was significantly lower than those in the poor effect group;CDUS examination: After thrombolysis, RI and PI in the good effect group were significantly lower than those in the poor effect group,and the incidence of intima-media thickening, plaque, stenosis and occlusion were significantly lower than those in the poor effect group;Serum detection: the levels of serum cates and CysC in the good effect group were significantly lower than those in the poor effect group;ROC curve analysis: seven indexes such as EDV, IMT and RI had good predictive value for thrombolytic effect. Conclusion The results of TCCS and CDUS combined with the levels of serum cats and CysC can effectively evaluate and predict the thrombolytic effect in patients with acute stroke.
作者 陈蝶 吴晶晶 韩笑 赵妍妍 Die Chen;Jingjing Wu;Xiao Han;Yanyan Zhao(Department of ultrasound,the First Affiliated Hospital of Hainan Medical College,Haikou,570102,China)
出处 《湖南师范大学学报(医学版)》 2022年第5期80-84,共5页 Journal of Hunan Normal University(Medical Sciences)
关键词 急性脑卒中 溶栓 血管超声 组织蛋白酶S 胱抑素C acute stroke thrombolysis vascular ultrasonography cathepsin S cystatin C
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