摘要
目的:探讨血清蛋白磷脂酶A2(Lp-PLA2)和同型半胱氨酸(Hcy)水平对急性脑梗死的影响。方法:采用前瞻性研究,选取2017年1月—2019年1月河北医科大学第二医院全科医疗科收治的105例急性脑梗死患者作为病例组,同期收集45例正常人员作为对照组。比较两组患者常规血生化指标、血清Hcy及Lp-PLA2含量,通过统计学分析引起患者发病的独立影响因素,通过受试者工作特征(ROC)曲线以探讨血清Lp-PLA2和Hcy对急性脑梗死的评估价值。结果:相比对照组,病例组尿素氮和高密度脂蛋白—胆固醇(HDL-C)浓度均明显下降,血肌酐、尿酸、总胆固醇(TC)、超敏C反应蛋白(hs-CRP)、Hcy及Lp-PLA2浓度均升高,差异有统计学意义(t=16.970、2.440、15.270、8.260、9.150、23.110、3.450、11.280,P<0.05);两组患者TC和LDL-C含量的比较,差异无统计学意义(t=1.510、1.250,P>0.05)。血清Hcy和Lp-PLA2含量均为发病的独立影响因子,差异有统计学意义(OR=1.880、1.680,P<0.05)。经ROC曲线分析结果显示,血清Hcy+Lp-PLA2联合检测对急性脑梗死的诊断效能高于单独检测,联合检测的ROC曲线下面积、敏感度和特异度均高于单一指标,差异有统计学意义(χ^(2)=11.140、12.830、13.340,P<0.05)。结论:Hcy和Lp-PLA2在急性脑梗死患者血清中的含量均显著增加,二者均为急性脑梗死发病的独立影响因子,二者联合检测对早期诊断急性脑梗死具有重要的效能。
Objective:To investigate the effect of protein phospholipase and serum homocysteine(Hcy)A2(Lp-PLA2)levels on acute cerebral infarction.Methods:With the prospective study,105 patients with acute cerebral infarction admitted to the hospital from January 2017 to January 2019 were selected as the case group and 45 normal persons were collected as the control group during the same period.The routine blood biochemical indices,serum Hcy and Lp-PLA2 levels were compared between the two groups of patients.The independent influencing factors causing patient morbidity were statistically analyzed and the value of serum Hcy and Lp-PLA2 for the assessment of acute cerebral infarction was explored by subject work characteristic(ROC)curves.Results:Compared with the control group,urea nitrogen and HDL-C concentrations were significantly decreased and blood creatinine,uric acid,TG,hs-CRP,Hcy and Lp-PLA2 concentrations were increased in the case group,with statistically significant differences(t=16.970,2.440,15.270,8.260,9.150,23.110,3.450,11.280,P<0.05).The differences in TC and LDL-C levels between the two groups were not statistically significant(t=1.510,1.250,P>0.05).The serum Hcy and Lp-PLA2 levels were both independent influencing factors for morbidity,with statistically significant differences(OR=1.880,1.680,P<0.05).The results of the ROC curve analysis showed that the diagnostic efficacy of the combined serum Hcy+Lp-PLA2 test for acute cerebral infarction was higher than that of the separate test,and the area under the ROC curve,sensitivity and specificity of the combined test were higher than those of the single index,with statistically significant differences(χ^(2)=11.140,12.830,13.340,P<0.05).Conclusion:The levels of both Hcy and Lp-PLA2 were significantly increased in the serum of patients with acute cerebral infarction,both of which are independent influencing factors in the development of acute cerebral infarction,and their combined detection has important efficacy for the early diagnosis of acute cerebral infarction.
作者
陶晓哲
王荣英
孙彦杰
付洁
孙萌萌
TAO Xiao-zhe;WANG Rong-ying;SUN Yan-jie(Department of Family Medicine,Second Hospital of Hebei Medical University,Shijiazhuang,Hebei,050000,China)
出处
《黑龙江医学》
2023年第9期1097-1099,共3页
Heilongjiang Medical Journal
关键词
急性脑梗死
同型半胱氨酸
脂蛋白磷脂酶A2
影响因素
诊断效能
Acute cerebral infarction
Homocysteine
Lipoprotein-associated phospholipase A2
Influencing factors
Diagnostic efficacy
作者简介
通信作者:王荣英,E-mail:quankeyiliaoke2y@163.com。
