干旱区生态环境知识资源中心(Arid): 微血管通透性预测老年人急性脑梗死出血性转化的灌注CT研究

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	微血管通透性预测老年人急性脑梗死出血性转化的灌注CT研究
其他题名	Predicting hemorrhagic transformation by microvascular permeability using perfusion CT in acute cerebral infarction in elderly patients
	田超; 杨天昊; 解中福; 崔世民
来源期刊	中华老年医学杂志
ISSN	0254-9026
出版年	2014
卷号	33 期号:4 页码:342-345
中文摘要	目的探讨采用灌注CT技术的微血管通透性(PS)测量值预测老年人急性脑梗死出血性转化(HT)的可能性。方法回顾分析接受静脉溶栓治疗的大脑中动脉供血区急性脑梗死患者52例,将患者分为HT组和对照组,HT组进一步分为出血性梗死组和脑血肿形成组。回顾性分析比较各组间发病6 h内灌注CT各项参数测量结果和CT血管造影源图像(CTA-SI)中Alberta卒中计划早期CT评分(ASPECTS)的统计学差异。结果52例患者中22例发生HT,其中出血性梗死14例,脑血肿形成8例。HT组患侧和对照组患侧的脑血流量及脑血流量值较健侧下降,PS值较健侧升高(均P<0.05)。HT组患侧PS值高于对照组患侧(P<0.01);而HT组患侧脑血流量及脑血流量值与对照组患侧的差异无统计学意义。PS值特异性曲线下面积为0.968,当PS≥5. 77 ml ?min~(-1) ? 100g~(-1)时,其预测HT的敏感度为95.5%,特异度为86.7%。HT组的ASPECTS低于对照组(Z= -5. 533,P<0. 01),出血性梗死组的ASPECTS高于脑血肿形成组(Z= -3. 771,P<0. 01),出血性梗死组与脑血肿形成组患侧各项灌注参数间差异无统计学意义。结论PS值显著升高可以作为预测HT风险、指导溶栓治疗的参考依据。
英文摘要	Objective To study the possibility of microvascular permeability (PS) value derived from perfusion CT (PCT) in predicting hemorrhagic transformation (HT) in acute cerebral infarction in elderly patients. Methods 52 consecutive patients with middle cerebral artery acute ischemic stroke who received thrombolytic therapy were divided into HT group and control group, and patients in HT group were further divided into hemorrhagic infarction (HI) group and parenchymal hematoma (PH) group. PCT data and Alberta stroke program early CT scores (ASPECTS) from CT angiography source images (CTA-SI) achieved within 6 hours after symptom onset of each group was retrospectively analyzed and statistically processed. Results In 52 patients,there were 22 cases developed HT, 14 cases with HI, 8 cases with PH. Cerebral blood flow (CBF) and cerebral blood volume (CBV) values were decreased and permeability surface area product (PS) was increased in ipsilateral in HT group and control group as compared with the contralateral (all P<0. 05). PS value in ipsilateral was significantly higher in HT group than in control group (P<0. 01),but CBF and CBV values in affected side showed no significant difference between the HT group and control group. The area under the receiver operator characteristic (ROC) curve of PS Az value was 0. 968. When PS ≥5. 77 ml ? min~(-1) ? 100 g~(-1),the sensitivity and specificity of predicting HT were 95. 5% and 86. 7% respectively. The ASPECTS was lower in HT group than in the control group (P<0. 01),arid ASPECTS was higher in HI group than in PH group (P<0. 01). The differences in PCT results in affected side between the HI group and PH group was not significant. Conclusions The significantly increased PS value can be a reference in predicting HT risk and guiding thrombolytic therapy.
中文关键词	血液灌注 ; 毛细血管通透性 ; 脑梗死 ; 出血
英文关键词	Hemoperfusion Capillary permeability Brain infarction Hemorrhage
语种	中文
国家	中国
收录类别	CSCD
WOS类目	MEDICINE GENERAL INTERNAL
WOS研究方向	General & Internal Medicine
CSCD记录号	CSCD:5122053
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/232284
作者单位	天津市环湖医院神经放射科, 天津 300060, 中国
推荐引用方式 GB/T 7714	田超,杨天昊,解中福,等. 微血管通透性预测老年人急性脑梗死出血性转化的灌注CT研究[J],2014,33(4):342-345.
APA	田超,杨天昊,解中福,&崔世民.(2014).微血管通透性预测老年人急性脑梗死出血性转化的灌注CT研究.中华老年医学杂志,33(4),342-345.
MLA	田超,et al."微血管通透性预测老年人急性脑梗死出血性转化的灌注CT研究".中华老年医学杂志 33.4(2014):342-345.