Study on the application value of CTPI parameters combined with serum biochemical indicators in the assessment of acute cerebral infarction and analysis of alteplase thrombolysis effects

Objective To investigate the application value of head CT perfusion imaging (CTPI) parameters combined with serum biochemical indicators in the evaluation of acute cerebral infarction (ACI) and analysis of the thrombolytic effects of ateplase.

Methods A total of 122 patients with ACI were selected, and divided into the mild group (NIHSS score ＜ 5) (29 cases), moderate group (NIHSS score 5-15) (66 cases) and severe group (NIHSS score ＞ 15) ( 27 cases) according to the National Institutes of Health Stroke Scale (NIHSS) score. All patients were given alteplase thrombolysis. According to the thrombolytic effect, the patients were divided into the effective group (84 cases) and ineffective group (38 cases). The CTPI parameters and serum biochemical indicators between two groups were compared, and the predictive value of combination of CTPI parameters and serum biochemical indicators for the thrombolytic effects was analyzed.

Results Comparison of the cerebral blood volume (CBV) and cerebral blood flow (CBF) between the moderate group and severe group: severe group ＜ moderate group ＜ mild group (P ＜ 0.05). Comparison of the mean transit time (MTT), time to peak (TTP), homocysteine (Hcy), uric acid and small dense low-density lipoprotein cholesterol (sdLDL-C): Severe group ＞ moderate group ＞ mild group, and the differences were all statistically significant (P ＜ 0.05). The CBF and CBV in the ineffective group were lower than those in effective group (P ＜ 0.05), while the TTP, MTT, Hcy, uric acid and sdLDL-C in the ineffective group were significantly higher than those in effective group (P ＜ 0.01). The results of ROC curve analysis showed that the AUCs of CBF, CBV, TTP, MTT, Hcy, uric acid, sdLDL-C and combined prediction of thrombolytic effect were 0.834, 0.625, 0.756, 0.686, 0.699, 0.722, 0.709, and 0.938, respectively.

Conclusions The more severe the ACI condition is, the lower the CBF and CBV will be, and the higher the TTP, MTT, Hcy, uric acid and sdLDL-C will be. The CTPI parameter combined with serum biochemical indicators has a high predictive value in the thrombolytic effect of ACI.The more severe the condition of ACI, the lower the CBF and CBV, and the higher the TTP, MTT, Hcy, uric acid, and sdLDL-C. The combination of CTPI parameters and serum biochemical indicators has high predictive value in the thrombolytic effect of ACI.