Abstract: The clinical data of 100 patients with clinically confirmed toxic shock admitted to our hospital from December 2017 to November 2018 were selected. All the patients underwent CT perfusion imaging.The original images were processed by the perfusion software in the workstation to produce pseudo-color images of perfusion parameters. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), peak time (TTP) of the lesion side and the contralateral cerebral hemisphere was measured, and other perfusion parameters(rCBF, rCBV, rMTT, rTTP) were used to calculate the relative ratio of lesion side to opposite side. The expression of claudin-5, occludin, ZO-1, JAM-1, NOS and NSE in different patients were detected by immunohistochemical method, and the correlation between the protein levels and the perfusion paraneters was compared. The results showed that rCBF in peripheral blood and cerebrospinal fluid decreased significantly, rTTP decreased and rPS increased significantly in the observation group (P<0.05), but there was no significant difference in rMTT and rCBV between the two groups (P>0.05). The claudin-5, occludin, ZO-1 and NOS in peripheral blood and cerebrospinal fluid of the patients in the observation group decreased significantly, while JAM-1 and NSE increased significantly (P<0.05). In the observation group, claudin-5, occludin, ZO-1 and NOS were positively correlated with rCBF and rTTP, negatively correlated with rPS; JAM-1 and NSE were negatively correlated with rCBF and rTTP, and positively correlated with rPS. rCBF, rTTP, JAM-1 and NSE were positively correlated with neuronal injury, while claudin-5, occludin, ZO-1 and NOS were negatively correlated with neuronal injury. It is suggested that CT blood perfusion combined with blood brain barrier marker protein can effectively evaluate neuronal damage in patients with toxic shock, and it is worth popularizing and applying.

Key words: CT perfusion imaging, blood-brain barrier marker protein, toxic shock, neuron injury