血清SOST、ACLA联合CT脑灌注对诊断老年患者脑动脉狭窄的预测价值

Predictive value of serum SOST and ACLA combined with CT perfusion in diagnosis of cerebral artery stenosis in elderly pa-tients

中文关键词: 老年, 脑动脉狭窄, 骨硬化蛋白, 抗心磷脂抗体, CT脑灌注

英文关键词: elderly  cerebral artery stenosis  osteosclerosis protein  anti-cardiolipin antibody  CT cerebral perfusion

中文摘要:

      目的 分析血清骨硬化蛋白(sclerostin,SOST)、抗心磷脂抗体(anticardiolipin antibody,ACLA)联合CT脑灌注(computed tomography perfusion,CTP)检查对脑动脉狭窄的预测价值.方法 选取2023年5月-2024年5月在复旦大学附属华东医院治疗的脑动脉狭窄的80例老年患者为研究对象,进行脑血管数字减影血管造影(digital subtraction angi-ography,DSA)检测.将70例脑动脉狭窄患者为观察组,另外选取65例同期体检健康者为对照组.检测血清SOST、ACLA水平,进行CTP检查,ROC曲线分析血清SOST、ACLA联合CTP对脑动脉狭窄的预测价值.结果 与对照组相比,观察组 SOST、ACLA-IgM、ACLA-IgG 水平、MTT、TTP 参数较高,脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)参数较低(P＜0.05).与轻度组相比,中度、重度/闭塞组 SOST、ACLA-IgM、ACLA-IgG 水平、平均通过时间(mean transmit time,MTT)、达峰时间(time to peak,TTP)参数较高,CBF、CBV参数较低(P＜0.05);与中度组相比,重度/闭塞组SOST、ACLA-IgM、ACLA-IgG水平、MTT、TTP参数较高,CBF、CBV参数较低(P＜0.05).血清SOST、ACLA-IgM、ACLA-IgG与CBF、CBV呈负相关,与MTT、TTP呈正相关(P＜0.05).相关性分析结果显示,SOST、ACLA-IgM、ACLA-IgG、MTT、TTP与狭窄程度呈正相关,CBF、CBV与狭窄程度呈负相关(P＜0.05).采用ROC分析显示,血清SOST、ACLA-IgM、ACLA-IgG、CTP联合检测对脑动脉狭窄的预测价值较高(P＜0.05).结论 在脑动脉狭窄患者体内,SOST、ACLA-IgM、ACLA-IgG水平、MTT、TTP参数较高,CBF、CBV参数较低.随着血管狭窄程度的加重,SOST、ACLA-IgM、ACLA-IgG水平、MTT、TTP参数逐渐升高,CBF、CBV参数降低.联合检测血清SOST、ACLA、CTP参数,对脑动脉狭窄的预测价值较高.

英文摘要:

      Objective To analyze the predictive value of serum sclerostin(SOST),anticardiolipin antibody(ACLA)combined with computed tomography perfusion(CTP)examination for cerebral artery stenosis.Methods 80 elderly patients with cerebral artery stenosis treated in Huadong Hospital Affiliated to Fudan University from May 2023 to May 2024 were se-lected as the study subjects.They all underwent digital subtraction angiography(DSA)examination.70 patients with cerebral artery stenosis were selected as the observation group,and an additional 65 healthy subjects who underwent physical examina-tions during the same period were selected as the control group.The levels of serum SOST and ACLA were detected and CTP was performed.ROC curve was used to analyze the predictive value of serum SOST and ACLA combined with CTP for cerebral artery stenosis.Results Compared with the control group,the levels of SOST,ACLA-IgM,ACLA-IgG,MTT,TTP,cere-bral blood flow(CBF)and cerebral blood volume of the observation group were higher,and the CBV parameters were lower(P＜0.05).Compared with the mild group,the levels of SOST,ACLA-IgM,ACLA-IgG,mean transmit time(MTT)and time to peak(TTP)of the moderate group and severe/occlusion groups were higher,while the levels of CBF and CBV were lower(P＜0.05).Compared with moderate group,the levels of SOST,ACLA-IgM,ACLA-IgG,MTT and TTP of the se-vere/block group were higher,while the levels of CBF and CBV were lower(P＜0.05).Serum SOST,ACLA IgM and ACLA IgG were negatively correlated with CBF and CBV,but positively correlated with MTT and TTP(P＜0.05).The cor-relation analysis results showed that SOST,ACLA IgM,ACLA IgG,MTT,TTP were positively correlated with the degree of stenosis,while CBF and CBV were negatively correlated with the degree of stenosis(P＜0.05).ROC analysis showed that the combined detection of serum SOST,ACLA-IgM,ACLA-IgG and CTP had high predictive value for cerebral artery stenosis(P＜0.05).Conclusion In patients with cerebral artery stenosis,the levels of SOST,ACLA-IgM,ACLA-IgG,MTT and TTP were higher,while the levels of CBF and CBV were lower.With the aggravation of vascular stenosis,the levels of SOST,ACLA-IgM,ACLA-IgG,MTT and TTP gradually increased,while the levels of CBF and CBV decreased.The combined de-termination of serum SOST,ACLA and CTP has high predictive value for cerebral artery stenosis.