OBJECTIVE: To analyze the clinical value of MRI combined with serum endolipin and Gal-3 for the diagnosis of cerebral infarction in the elderly with diabetes mellitus.
METHODS: One hundred and fifty patients with acute cerebral infarction hospitalized between January 2021 and December 2023 were divided into two groups according to comorbid diabetes mellitus, including 62 and 88 cases in the diabetic and nondiabetic cerebral infarction groups. Serum samples were collected to detect the expression of serum endolipoxins, and Gal-3, and cranial MRI was performed at admission. Differences between the two groups were compared to analyze the diagnostic value of these parameters.
RESULTS: Serum endolipin and Gal-3 expression were higher in the diabetic cerebral infarction group (P < 0.05). The arterial wall area, vessel area, normalized wall index, and lumen stenosis rate were higher in the diabetic cerebral infarction group, while the rate of arterial lumen moderate and severe stenosis was 48.39% higher (36.36%, P < 0.05). The percentage of large (29.03%) and multiple infarcts (33.87%) in the diabetic cerebral infarction group was higher (13.64% and 20.45%), and the incidence rate of lacunar infarcts was lower (37.10% vs 65.91%) (P < 0.05). The total incidence of arterial plaque in patients in the diabetic cerebral infarction group was 96.77% higher (69.32%), while the incidence of necrotic lipid core plaque was 58.06% higher (26.14%) (P < 0.05). Receiver operating characteristic curve analysis was performed to assess the diagnosis utility of these techniques. MRI in combination with serum endoglin and Gal-3 had the highest area under the curve, the Yoden index, sensitivity and specificity (P < 0.05).
CONCLUSIONS: The expression of serum endolipin and Gal-3 in elderly patients with diabetes mellitus with cerebral infarction showed an elevated trend, and the degree of luminal stenosis was severe. MRI predominantly revealed large and multiple infarct foci. This combined index examination can improve the clinical diagnosis of diabetes mellitus combined with cerebral infarction.
目的:分析MRI联合血清内胆苷和Gal-3诊断老年糖尿病合并脑梗死的临床价值。
方法:将2021年1月至2023年12月住院的150例急性脑梗死患者按合并糖尿病分为两组,其中糖尿病和非糖尿病脑梗死组62例和88例。收集血清样本检测血清内皮素的表达,和Gal-3,入院时进行头颅MRI检查。比较两组之间的差异,分析这些参数的诊断价值。
结果:糖尿病性脑梗死组血清内胆素和Gal-3表达明显增高(P<0.05)。动脉壁面积,船舶面积,归一化墙指数,糖尿病性脑梗死组的管腔狭窄率较高,而动脉管腔中度和重度狭窄的发生率高出48.39%(36.36%,P<0.05)。大梗死(29.03%)和多发梗死(33.87%)在糖尿病脑梗死组中的比例较高(13.64%和20.45%),腔隙性脑梗死发生率较低(37.10%vs65.91%)(P<0.05)。糖尿病性脑梗死组患者动脉斑块总发生率高96.77%(69.32%),而坏死脂质核心斑块的发生率高58.06%(26.14%)(P<0.05)。进行了接收器工作特征曲线分析以评估这些技术的诊断实用性。MRI结合血清endoglin和Gal-3的曲线下面积最高,Yoden指数,敏感性和特异性(P<0.05)。
结论:老年糖尿病合并脑梗死患者血清内凝素和Gal-3的表达呈升高趋势。管腔狭窄程度严重。MRI主要显示较大和多个梗死灶。该联合指标检查可提高糖尿病合并脑梗死的临床诊断水平。