SCTA诊断急性脑梗死颈动脉狭窄的临床研究和早期针刺对其神经功能及超敏C反应蛋白的影响

刘鸿雁

【摘要】 目的：分析多層螺旋CT血管造影（SCTA）在急性脑梗死颈动脉狭窄中的诊断价值和予以急性脑梗死患者早期针刺对其神经功能和超敏C反应蛋白（hs-CRP）的影响。方法：选择2019年1-12月本院收治的98例急性脑梗死患者，均开展SCTA检查，并将X线血管造影（DSA）结果作为金标准，计算SCTA在颈动脉狭窄诊断中的准确度、敏感度和特异度。依据随机数字表法将患者分成对照组和观察组，每组49例。对照组采用常规治疗，观察组在对照组基础上开展早期针刺。比较两组治疗前后神经功能缺损（NIHSS评分）与hs-CRP水平。结果：SCTA对颈动脉狭窄的诊断准确度、敏感度及特异度分别为94.67%、96.82%、89.71%。SCTA检查出轻、中、重度狭窄和完全闭塞分别为72、44、35、8支，DSA检查出轻、中、重狭窄和完全闭塞分别为76、45、31、5支。治疗后，观察组的NIHSS评分和hs-CRP水平均低于对照组，差异均有统计学意义（P<0.05）。结论：SCTA在急性脑梗死颈动脉狭窄诊断中有着较高准确度、敏感度和特异度，予以急性脑梗死患者早期针刺能改善其神经功能，降低其炎症水平。

【关键词】 急性脑梗死 颈动脉狭窄 多层螺旋CT血管造影 早期针刺 超敏C反应蛋白 神经功能

Clinical Study of SCTA in the Diagnosis of Carotid Artery Stenosis in Acute Cerebral Infarction and the Effect of Early Acupuncture on Neurological Function and High Sensitivity C-reactive Protein/LIU Hongyan. //Medical Innovation of China， 2021， 18（16）： -108

[Abstract] Objective： To analyze the diagnostic value of multi-slice spiral CT angiography （SCTA） in acute cerebral infarction patients with carotid artery stenosis and the effect of early acupuncture on the neurological function and high sensitivity C-reactive （hs-CRP） in patients with acute cerebral infarction. Method： A total of 98 patients with acute cerebral infarction admitted to our hospital from January to December 2019 were selected for SCTA examination， and X-ray angiography （DSA） results were taken as the gold standard. The accuracy， sensitivity and specificity of SCTA in the diagnosis of carotid artery stenosis were calculated. According to random number table method， the patients were divided into control group and observation group， 49 cases in each group. The control group was treated with routine treatment， and the observation group was treated with early acupuncture on the basis of the control group. Neurological deficit （NIHSS scores） and hs-CRP levels were compared between the two groups before and after treatment. Result： The accuracy， sensitivity and specificity of SCTA in the diagnosis of carotid stenosis were 94.67%， 96.82% and 89.71%， respectively. SCTA detected mild， moderate and severe stenosis and complete occlusion were 72， 44， 35 and 8， respectively， while DSA detected mild， moderate and severe stenosis and complete occlusion were 76， 45， 31 and 5， respectively. After treatment， the NIHSS score and hs-CRP level in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： SCTA has high accuracy， sensitivity and specificity in the diagnosis of carotid artery stenosis in acute cerebral infarction. Early acupuncture in patients with acute cerebral infarction can improve their neurological function and reduce their inflammation level.

[Key words] Acute cerebral infarction Carotid artery stenosis Multi-slice spiral CT angiography Early acupuncture High sensitivity C-reactive Nerve function

First-author’s address： Dingtao District People’s Hospital， Heze 274100， China

doi：10.3969/j.issn.1674-4985.2021.16.025

脑梗死作为中枢神经系统一种常见疾病，高达85%属于缺血性脑梗死，而颈动脉狭窄及粥样硬化斑块生成是其重要的病理基础[1-2]。临床诊断存在症状的缺血性脑梗死难度不高，但诊断血管狭窄度程度时需结合影像学手段。X线血管造影（DSA）作为检查血管狭窄的金标准，价格较昂贵，同时有一定创伤。多层螺旋CT血管造影（SCTA）属于近年来发展较快的一类检查方式，有着较高的分辨率，同时后处理功能较为强大，在诊断颈动脉狭窄中有着重要价值[3-4]。……