Prediction effect of transcranial color Doppler ultrasound combined with blood sCD40L, Fib and PAF on cerebral infarction after transient ischemic attack

doi:10.3877/cma.j.issn.2095-9141.2023.04.005

Abstract

Abstract:

Objective

To investigate the predictive effect of transcranial color Doppler ultrasound (TCCS) combined with soluble CD40 ligand (sCD40L), fibrinogen (Fib) and platelet activating factor (PAF) on cerebral infarction after transient ischemic attack (TIA).

Methods

A total of 128 TIA patients diagnosed and treated by Ultrasound Diagnostic Department of the 82^nd Group Military Hospital of PLA from May 2020 to June 2021 were retrospectively selected as the study objects, and were divided into cerebral infarction group (n=36) and non-cerebral infarction group (n=92) according to whether secondary cerebral infarction occurred within 7 d after TIA. TCD blood flow parameters [middle cerebral artery (MCA), peak systolic blood flow velocity (V_S), end-diastolic blood flow velocity (V_d), pulsation index (PI), resistance index (RI)], sCD40L, Fib, and PAF were compared between the two groups. ROC curve model was used to analyze the predictive value of color Doppler ultrasound blood flow parameters (V_S, V_d, PI, and RI), sCD40L, Fib, PAF and the four combinations in TIA patients with secondary cerebral infarction.

Results

V_S and V_d in cerebral infarction group were lower than those in non-cerebral infarction group, while PI and RI were higher than those in non-cerebral infarction group (P<0.05). The sCD40L, Fib, and PAF levels in cerebral infarction group were higher than those in non-cerebral infarction group (P<0.05). ROC curve analysis showed that the AUC values of V_S, V_d, PI, RI, sCD40L, Fib, PAF and the combined prediction of TIA patients with secondary cerebral infarction were 0.609, 0.772, 0.673, 0.625, 0.677, 0.743, 0.768, 0.944 (P<0.05). Sensitivity was 50.00%, 88.90%, 41.70%, 47.20%, 50.00%, 52.80%, 58.30%, and 86.10%, respectively. The specificity was 93.50%, 62.00%, 97.80%, 100.00%, 92.40%, 90.20%, 93.50%, and 90.20%, respectively. V_S, V_d, PI, RI, sCD40L, Fib, PAF were compared with the four combined AUC, and the differences were statistically significant (Z=4.095, 3.628, 4.304, 4.463, 4.178, 3.503, 3.117, all P<0.001).

Conclusion

TCD, sCD40L, Fib, and PAF all have certain value in predicting secondary cerebral infarction in TIA patients, but the combined prediction efficiency of the four items is higher.

Key words: Transient ischemic attack, Cerebral infarction, Transcranial color Doppler ultrasound, Soluble CD40 ligand, Fibrinogen, Platelet activating factor

Jing Wang, Bin He. Prediction effect of transcranial color Doppler ultrasound combined with blood sCD40L, Fib and PAF on cerebral infarction after transient ischemic attack[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2023, 09(04): 222-227.

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References 20

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组别	例数	性别[例（%）]		年龄（岁，±s）	BMI（kg/m²，±s）	TIA持续发作时间（min，±s）	高血压[例（%）]	糖尿病[例（%）]
组别	例数	男性	女性	年龄（岁，±s）	BMI（kg/m²，±s）	TIA持续发作时间（min，±s）	高血压[例（%）]	糖尿病[例（%）]
脑梗死组	36	18（50.00）	18（50.00）	58.33±6.85	23.45±2.32	42.32±5.65	21（58.33）	12（33.33）
非脑梗死组	92	48（52.17）	44（47.83）	58.38±6.89	23.51±2.38	42.39±5.70	43（46.74）	21（22.83）
χ²/t值		0.049		0.037	0.129	0.063	1.391	1.493
P值		0.825		0.971	0.897	0.950	0.238	0.222

组别	例数	性别[例（%）]		年龄（岁，±s）	BMI（kg/m²，±s）	TIA持续发作时间（min，±s）	高血压[例（%）]	糖尿病[例（%）]
组别	例数	男性	女性	年龄（岁，±s）	BMI（kg/m²，±s）	TIA持续发作时间（min，±s）	高血压[例（%）]	糖尿病[例（%）]
脑梗死组	36	18（50.00）	18（50.00）	58.33±6.85	23.45±2.32	42.32±5.65	21（58.33）	12（33.33）
非脑梗死组	92	48（52.17）	44（47.83）	58.38±6.89	23.51±2.38	42.39±5.70	43（46.74）	21（22.83）
χ²/t值		0.049		0.037	0.129	0.063	1.391	1.493
P值		0.825		0.971	0.897	0.950	0.238	0.222

组别	例数	V_S（cm/s）	V_d（cm/s）	PI	RI
脑梗死组	36	72.25±16.45	28.84±4.85	1.02±0.23	0.62±0.19
非脑梗死组	92	83.45±11.33	35.32±7.05	0.87±0.14	0.55±0.12
t值		4.397	5.060	4.492	2.491
P值		<0.001	<0.001	<0.001	0.014

组别	例数	V_S（cm/s）	V_d（cm/s）	PI	RI
脑梗死组	36	72.25±16.45	28.84±4.85	1.02±0.23	0.62±0.19
非脑梗死组	92	83.45±11.33	35.32±7.05	0.87±0.14	0.55±0.12
t值		4.397	5.060	4.492	2.491
P值		<0.001	<0.001	<0.001	0.014

组别	例数	sCD40L（µg/L）	Fib（g/L）	PAF（ng/mL）
脑梗死组	36	223.52±56.52	4.05±0.85	102.33±18.65
非脑梗死组	92	185.87±37.96	3.27±0.68	85.65±12.05
t值		4.362	5.426	5.977
P值		<0.001	<0.001	<0.001

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