摘要
目的探究磁共振成像(MRI)联合血清半胱氨酸蛋白酶-1(caspase-1)、白细胞介素-6(IL-6)检测在早产儿脑白质损伤中的诊断价值。方法选取该院2015年3月至2016年6月新生儿ICU病房57例脑白质损伤早产儿作为研究对象,另选取39例该院同期出生无脑损伤早产儿作为对照组,采用脑部MRI仪对所有早产儿进行检测,观察所有早产儿MRI及弥散加权成像(DWI)信号变化,对早产儿出生1、3、7d血清中caspase-1、IL-6水平进行测定;创建受试者工作特征曲线(ROC),计算MRI、caspase-1、IL-6单独检测及联合检测的曲线下面积(AUC)值。结果对照组常规MRI信号显示正常,T1加权信号加强。观察组中有10例DWI显示高信号,MRI信号正常;32例DWI显示信号增强,MRI显示T1加权信号增强,偶伴有T2低信号;15例DWI信号正常,MRI检测显示为T1加权信号增强,偶伴有T2信号减弱;线状损伤6例,簇状损伤14例,点状损伤37例。观察组血清中caspase-1、IL-6在1、3、7d水平均显著高于对照组,差异有统计学意义(P<0.05)。MRI、血清caspase-1、IL-6单独检测时三者灵敏度、特异度、准确度、AUC值差异无统计学意义(P>0.05);三者联合检测后AUC值明显升高,明显高于两两联合检测AUC值(P<0.05)。结论 MRI联合血清caspase-1、IL-6检测对早产儿脑白质损伤诊断有较好的临床应用价值。
Objective To explore the diagnostic value of magnetic resonance imaging（MRI） combined with serum cysteine pro- teinase-l（caspase-1） and interleukin-6（IL-6） in preterm infants with white matter damage. Methods A total of 57 cases of premature infants in neonatal ICU ward from March 2015 to June 2016 were selected as the research objects,and another 39 cases of pre- term infants without brain damage born in our hospital during the same period were selected as control group,all the premature in- fantsr brain were detected by MRI instrument,the changes of MRI and DWI signals in all preterm infants were observed,the levels of IL-6 and caspase-1 in the serum of I d,3 d and 7 d were measured in preterm infants. The receiver operating characteristic curve （ROC） was created, the AUC value of MRI, caspase-1, IL-6 single detection and joint detection were calculated. Results In the con- trol group,the MRI signal was normal,and the T1 weighted signal was enhanced. In the observation group,there were 10 cases of DWI showed high signal, MRI signal was normal, DWI of 32 cases was showed signal enhanced, MRI showed T1 weighted signal enhanced, even with T2 low signal occasionally; in another 15 cases, the single of DWI was normal, MRI showed T1 weighted signal enhanced,even with T2 low signal occasionally. There were 6 cases were linear injury, 14 cases were cluster injury,and 37 cases were point injury. The serum levels of caspase-1 and IL-6 in the observation group were significantly higher than those in the con- trol group in the 1 d, 3 d, and 7 d（P〈0.05）. The sensitivity, specificity, accuracy and AUC value of MRI, serum caspase-1 and IL- 6 detected separately had no significant difference, the premature brain white matter injury diagnosis effect was similar（P〉0.05）. AUC value was significantly higher after combined detection of three indexes,which was significantly higher than the combined de- tections of two indexes（P〈0.05）. Conclusion MRI combined with caspase-1 and IL-6 in the detection of white matter damage in premature infants has good clinical application value.
作者
李扬
LI Yang(Department of Magnetic Resonance Imaging, Third Hospital of Qinhuangdao ,Qinhuangdao, Hebei 066001, China)
出处
《检验医学与临床》
CAS
2017年第15期2211-2213,共3页
Laboratory Medicine and Clinic
基金
河北省秦皇岛市科学技术局项目(201602A054)
