患者基线颈动脉斑块对比增强超声定量分析对TIA患者再发脑梗死的预测价值

目的 探讨颈动脉斑块对比增强超声(Contrast-enhanced ultrasound,CEUS)定量分析对短暂性脑缺血发作(Transient ischemic stroke,TIA)患者再发脑梗死的预测价值。方法 纳入2018年2月-2019年2月收治的94例老年TIA患者为研究对象,入院时采集患者人口学资料、临床特征资料,所有患者均接受常规TIA治疗,并收集治疗后患者临床资料,治疗后随访2年,记录94例老年TIA患者再发脑梗死情况,根据患者是否再发生脑梗死分为再发组和未再发组; 采用Cox回归方程分析老年TIA患者再发脑梗死的预测因子并构建预测模型,分析其预测效能。结果 94例老年TIA患者截止最后随访日期2021年2月21日,出现12例失访,最终纳入82例患者,其中33例患者出现再发脑梗死为再发组,49例未出现再发脑梗死为未再发组; 单变量分析显示2组甘油三酯(Triglyceride,TG)、低密度脂蛋白(Low density lipoprotein,LDL)、血栓调节蛋白水平有明显差异(P<0.05); Cox分析显示LDL(HR=0.026)、血栓调节蛋白(HR=0.029)、峰值时间信号强度(Parameters of time-intensity curve,P TIC)(HR=0.030)、清晰度(Sharpness,S FC)(HR=0.020),曲线下面积(Under the curve area,AUC FC)(HR=0.043)是老年TIA后再发脑梗死的预测因子; 列线图模型预测老年TIA后再发脑梗死的C-指数为0.881,校正曲线显示绝对误差为0.034。结论 基于基线LDL、血栓调节蛋白、P TIC,S FC,AUC FC建立的老年TIA后再发脑梗死预测模型具备较高的预测效能。

Predictive value analysis of CEUS quantitative analysis of carotid plaque for recurrent stroke in patients with TIA

Objective To explore the predictive value of carotid plaque contrast-enhanced ultrasound(CEUS)quantitative analysis for recurrent stroke in patients with transient ischemic attack(TIA).Methods Ninety-four elderly patients with TIA admitted to our hospital from February 2018 to February 2019 were included as the research objects. Demographic data and clinical characteristics of the patients were collected upon admission. All patients received conventional TIA treatment, and clinical data of the patients were collected with 2 years of followed up. Recurrence of stroke in elderly 94 patients with TIA was recorded. Patients were divided into the recurrence group and non-recurrence group according to whether the patients relapse. Cox regression equation was used to analyze the predictive factors of recurrence of stroke in elderly TIA patients, and a predictive model was designed to evaluate its prediction.Results As of the last follow-up date of February 21, 2021, among the 94 elderly patients with TIA, 12 cases were lost to follow up, and 82 patients were finally enrolled. 33 patients with recurred strokes were classified as the recurrence group, and 49 patients without recurred strokes were regarded as the non-recurrence group. Univariate analysis showed that the levels of TG, LDL, thrombomodulin were significantly different between the two groups(P<0.05); Cox analysis showed that LDL(HR=0.026), thrombomodulin(HR=0.029), P TIC(HR=0.030), S FC(HR=0.020), AUC FC(HR=0.043)are the predictors of recurrence of the stroke after TIA in the elderly; the nomogram model revealed that the C-index of recurrence of the stroke after TIA in the elderly was 0.881, and the calibration curve of the absolute error displayed was 0.034.Conclusion The predictive model which was established on the independent predictors of recurrent stroke such as LDL, thrombomodulin, P TIC, SFC and AUC FC can provide high predictive value of the recurrence of the stroke after TIA in the elderly.