| 李尊强,马慧兰,晏楠楠,刘奎环,陈 萍,颜庭超,王俊平.CT血管造影联合血浆PON-1、CHI3L1在缺血性脑卒中患者颈动脉狭窄中的应用价值[J].,2025,(1):161-167 |
| CT血管造影联合血浆PON-1、CHI3L1在缺血性脑卒中患者颈动脉狭窄中的应用价值 |
| Application Value of CT Angiography Combined with Plasma PON-1 and CHI3L1 in Carotid Artery Stenosis in Ischemic Stroke Patients |
| 投稿时间：2024-10-14 |
| DOI：10.13241/j.cnki.pmb.2025.01.023 |
| 中文关键词: 缺血性脑卒中 颈动脉狭窄 计算机断层扫描血管造影 对氧磷脂酶1 壳多糖酶3样蛋白1 |
| 英文关键词: Ischemic stroke Carotid artery stenosis Computed tomography angiography Paraoxonase-1 Chitinase 3-like protein 1 |
| 基金项目:盘锦市科学技术项目（20210101） |
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| 中文摘要: |
| 摘要 目的：探讨计算机断层扫描血管造影（CTA）联合血浆对氧磷脂酶1（PON-1）、壳多糖酶3样蛋白1（CHI3L1）对缺血性脑卒中患者颈动脉狭窄的诊断价值。方法：选取2021年6月至2024年3月我院收治的86例缺血性脑卒中患者，均行CTA检查和数字减影血管造影（DSA）检查，根据患者是否存在颈动脉狭窄将其分为狭窄组（n=45例）和无狭窄组（n=41例）。采用Kappa检验CTA与DSA检查结果的一致性，采用受试者工作特征（ROC）曲线分析CTA联合血浆PON-1、CHI3L1诊断缺血性脑卒中患者颈动脉狭窄的价值。结果：DSA检查结果显示，86例缺血性脑卒中患者中，无颈动脉狭窄41例，存在颈动脉狭窄45例（其中轻、中、重度狭窄分别13、19、7例，闭塞6例）。CTA准确检出存在颈动脉狭窄31例（其中轻、中、重度狭窄分别8、15、5例，闭塞3例），准确率为68.89%（31/45）。CTA检查结果与DSA检查结果一致性中等（Kappa值=0.419，P＜0.05）。狭窄组血浆PON-1水平低于无狭窄组，血浆CHI3L1水平高于无狭窄组（P＜0.05）。CTA、血浆PON-1、CHI3L1单独诊断缺血性脑卒中患者颈动脉狭窄的曲线下面积（AUC）分别为0.710、0.722、0.681，联合诊断的AUC为0.846，高于各指标单独诊断（Z=3.093、2.411、2.774，P＜0.05）。结论：存在颈动脉狭窄的缺血性脑卒中患者血浆PON-1水平降低，CHI3L1水平增高，CTA联合血浆PON-1、CHI3L1对缺血性脑卒中患者颈动脉狭窄具有较高的诊断价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the diagnostic value of computed tomography angiography (CTA) combined with plasma paraoxonase-1 (PON-1) and chitinase 3-like protein 1 (CHI3L1) in carotid artery stenosis in ischemic stroke patients. Methods: 86 ischemic stroke patients who were admitted in our hospital from June 2021 to March 2024 were selected, all patients underwent CTA and digital subtraction angiography (DSA), patients were divided into stenosis group (n=45 cases) and non-stenosis group (n=41 cases) according to the presence or absence of carotid artery stenosis. The consistency of CTA and DSA results was tested by Kappa, the value of CTA combined with plasma PON-1 and CHI3L1 in the diagnosis of carotid artery stenosis in ischemic stroke patients was analyzed by receiver operating characteristic (ROC) curve. Results: The results of DSA examination showed that, among 86 ischemic stroke patients, there were 41 cases without carotid stenosis, and 45 cases with carotid stenosis (there were 13 cases of mild stenosis, 19 cases of moderate stenosis, 7 cases of severe stenosis and 6 cases of occlusion). CTA accurately detected 31 cases of carotid artery stenosis ( including 8 cases of mild, 15 cases of moderate and 5 cases of severe stenosis, and 3 cases of occlusion), with an accuracy rate of 68.89% (31/45). The consistency between CTA and DSA was moderate (Kappa value=0.419, P<0.05). The plasma PON-1 level in stenosis group was lower than that in non-stenosis group, and the plasma CHI3L1 level was higher than that in non-stenosis group (P<0.05). The area under the curve (AUC) of CTA, plasma PON-1 and CHI3L1 in the diagnosis of carotid artery stenosis in ischemic stroke patients were 0.710, 0.722 and 0.681, respectively, the AUC of combined diagnosis was 0.846, which was higher than that of each index (Z=3.093, 2.411, 2.774, P<0.05). Conclusion: The plasma PON-1 level decreased in ischemic stroke patients with carotid artery stenosis, and CHI3L1 level increased, CTA combined with plasma PON-1 and CHI3L1 has a high diagnostic value for carotid stenosis in ischemic stroke patients. |
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