CTP、CTA聯(lián)合血清NSE對(duì)腦卒中偏癱患者側(cè)支循環(huán)狀態(tài)及預(yù)后的評(píng)估價(jià)值

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中圖分類號(hào)：R743.3 文獻(xiàn)標(biāo)志碼：A DOI：10.11958/20250127

Abstract：ObjectiveTo investigate the value CTpeifusion imaging （CTP）CTangiography（CTA） combined with serm neuron-specificenolase （NSE）inassessng the status prognosis colateral cirulation（CC）inhemiplegic patientswith stroke.MethodsAtotal1O6patientswithstrokehemiplegia wereselected inthisstudy.All patients underwent CTA CTP， patients were classfied into the good CC group （ n =67） the poor CC group （ n =39） based on CTA images.Patients were also clasified into the good prognostic group（n=56） thepoor prognostic group （n=5O）based on modified Rankin Scale （mRS）scores after 3 months treatment.Enzyme-linked immunosorbentassy （ELISA）was used to detect serum NSE levels.Pearson correlationanalysis was used to analyse thecorelation between CCscores CTP parameters serum NSE levels.The receiver operating characteristic （ROC） curve was used toanalyze theevaluation value serum NSEfor the prognosis hemiplegic patients after stroke.Kappatestwas used toanalysethe consistency the prognosisfollow-upresults hemiplegic strokepatientsassessedbyCTP CTA alone incombination with serum NSE.ResultsThe CTP parameters rCBF rCBV werelowerin the poor CC groupthan those in the good CC group C ?P<0.05? ， levels rTTP，rMTT serum NSE were higher than those in the good CC group （ P<0.01 ）. CC score was positively correlated withrCBF rCBV， negatively correlated with rTTP，rMTT serum NSE levels （ P<0.05 ）. The rCBF rCBVwere lowerinthepoor prognosis groupthan those inthe good prognosis group， the proportion poor CC， rTTP，rMTT，serum NSE level mRS score were higher than those in the good prognosis group （ P<0.01 ）. The area under the curve serum NSEalone for predicting poor prognosis in hemiplegic patientswith stroke was 0.878（95%Cl： 0.800- 0.934），with a sensitivity 74.00% a specificity 91.07% ，which wasin good agreement with the results the followup （Kappa value=0.654， P<0.001 ）.Conclusion CTP，CTA combined with serum NSE have a relatively high evaluation value for the assessment the CC status prognosis stroke patients with hemiplegia.

Keywords： tomography，X-raycomputed; perfusion imaging; computed tomographyangiography;stroke;hemiplegia; collateral circulation; prognosis

腦卒中是導(dǎo)致殘疾和認(rèn)知缺陷的主要原因之二[1-2]。（剩余10439字）