超声造影定量参数联合同型半胱氨酸及超敏C-反应蛋白对缺血性脑卒中的预测价值

目的探讨超声造影峰值强度(TIC-P)、强度均值(TIC-M)、峰值(FC-P)、锐度(FC-S)、曲线下面积(FC-AUC)联合血清同型半胱氨酸(Hcy)及超敏C-反应蛋白(Hs-CRP)对缺血性脑卒中(ICS)的预测价值。方法选取儋州市人民医院行颈动脉超声检查发现颈动脉粥样硬化患者196例,根据其是否发生ICS,分为ICS组(n=91)和非ICS组(n=105)。记录各组的基线资料,并进行超声造影检查及Hcy及Hs-CRP水平检测。应用ROC曲线分析超声造影定量参数、Hcy及Hs-CRP预测ICS发生的价值。结果 ICS组颈动脉斑块超声造影定量参数TIC-P、TIC-M、FC-P、FC-S和FC-AUC值均明显高于非ICS组(P 0. 05)。ICS组Hcy及Hs-CRP水平均明显高于非ICS组(P 0. 01)。ROC曲线分析显示,三者联合预测ICS的AUC(95%CI)为0. 986 (0. 940～0. 998)明显高于单项超声造影定量参数0. 890 (0. 830～0. 951)、Hcy 0. 827 (0. 770～0. 885)及Hs-CRP 0. 795 (0. 737～0. 856),其预测ICS的敏感度(98. 5%)和特异度(93. 6%)均较高。相关分析显示,ICS患者超声造影定量参数FC-AUC与Hcy、Hs-CRP的相关性较好(r=0. 815、0. 792,P 0. 001)。结论超声造影定量参数联合Hcy及Hs-CRP水平能准确预测ICS的发生。

Value of contrast-enhanced ultrasound quantitative parameters combined with homocysteine and high-sensitivity C-reactive protein in predicting ischemic stroke

Objective To investigate the value of time-intensity curve peak intensity (TIC-P), time-intensity curve mean intensity (TIC-M), peak of the fitting curve (FC-P), sharpness of the fitting curve (FC-S), and area under the fitting curve (FC-AUC) combined with serum homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) in predicting ischemic stroke (ICS). Methods A total of 196 patients who were found to have carotid atherosclerosis by carotid artery ultrasound in Danzhou People's Hospital were enrolled, and according to the presence or absence of ICS, they were divided into ICS group with 91 patients and non-ICS group with 105 patients. The baseline data of each group were recorded, contrast-enhanced ultrasound was performed, and Hcy and hs-CRP levels were measured. The receiver operating characteristic (ROC) curve was used to analyze the value of quantitative parameters of contrast-enhanced ultrasound, Hcy, and hs-CRP in predicting the development of ICS. Results The ICS group had significantly higher quantitative parameters of carotid plaque contrast-enhanced ultrasound, TIC-P, TIC-M, FC-P, FC-S, and FC-AUC, than the non-ICS group (P<0.05). The ICS group had significantly higher Hcy and hs-CRP levels than the non-ICS group (P<0.01). The ROC curve analysis showed that combined measurement of quantitative parameters, Hcy, and hs-CRP had a significantly higher area under the ROC curve in predicting ICS than quantitative parameters, Hcy, or hs-CRP measured alone[0.986 (95%CI:0.940-0.998) vs 0.890 (95%CI:0.830-0.951)/0.827 (95%CI:0.770-0.885)/0.795 (95%CI:0.737-0.856)], and combined measurement of the three indices had a sensitivity of 98.5% and a specificity of 93.6% in predicting ICS. The correlation analysis showed that in the patients with ICS, FC-AUC was well correlated with Hcy and hs-CRP (r=0.815 and 0.792, P<0.001). Conclusions Contrast-enhanced ultrasound quantitative parameters combined with Hcy and hs-CRP levels can accurately predict the development of ICS.