泛素C末端水解酶-1在急性缺血性脑血管病早期鉴别中的应用价值  

Application value of ubiquitin C-terminal hydrolase-L1 in early identification of acute ischemic cerebrovascular disease

作　　者：张炜 苏萍 邝兆威 

机构地区：[1]东莞市塘厦医院,广东东莞523721

出　　处：《山东医药》2013年第24期15-17,共3页Shandong Medical Journal

基　　金：广东省东莞市科技计划项目(201210515032043)

摘　　要：目的评价血清泛素C末端水解酶-1(UCH-L1)在急性缺血性脑血管病早期鉴别中的应用价值。方法采用前瞻性设计,连续观察发病6 h内表现为急性局灶性神经功能缺损的患者102例,分为超急性脑梗死(HCI)组[除外腔隙性脑梗死(LACI)]40例、LACI组32例、短暂性脑缺血发作(TIA)组30例。用夹心ELISA法测定三组发病6 h内血清UCH-L1,采用受试者工作特征(ROC)曲线分析血清UCH-L1对HCI的诊断价值。结果 HCI、LA-CI、TIA组血清UCH-L1水平分别为0.24(0.21)、0.13(0.09)、0.13(0.07)μg/L,HCI组血清UCH-L1水平显著高于LACI、TIA组(P均<0.001),LACI组血清UCH-L1水平与TIA组无显著性差异(P>0.05)。血清UCH-L1诊断HCI(除外LACI)的ROC曲线下面积为0.793±0.047(P<0.01,95%CI 0.700～0.886),最佳截断点血清UCH-L1水平为0.17μg/L。当血清UCH-L1≥0.17μg/L时,其诊断HCI的灵敏度为72.5%、特异度为74.2%、阳性预测值为64.4%、阴性预测值为80.7%。结论血清UCH-L1水平检测有助于HCI与TIA、LACI的早期鉴别。Objective To evaluate the application value of ubiquitin C-terminal hydrolase-L1 （ UCH-L1 ） in early i- dentification of acute ischemic cerebrovascular disease. Methods A total of 102 patients with the sudden appearance of focal neurological deficit within 6 from onset were observed in this prospective study and then they were divided into hyperacute cerebral infarction （HCI） group （except for lacunar infarction） 40 cases, lacunar infarction （LACI） group 32 cases and transient ischemic attack （T1A） group 30 eases. Serum UCH-L1 in three groups within 6 from onset was determined by ELISA. The value of serum UCH-L1 in diagnosing HCI was analyzed with receiver operating characteristic （ROC） curve. Results The level of serum UCH-L1 in HCI group, LACI group and TIA group were 0.24 （0.21） μg/L, 0.13 （0.09） μg/L and 0.13 （0.07） μg/L respectively. The level of serum UCH-L1 was significantly higher in HCI group than those in LACI and TIA groups （all P 〈 0.001 ）. The level of serum UCH-L1 in LACI group had no difference with the level of ser- um UCH-L1 in TIA group （P 〉 0.05 ）. The area under ROC curve for serum UCH-L1 in diagnosing HCI （except for LA- CI） was （0. 793 ± 0. 047 ） （ P 〈 0. 001,95 % CI： 0. 700 - 0. 886 ） , serum level of UCH-L1 was 0.17μg/L on optimal cut- off. When level of serum UCH-LI was over or equal to 0.17 p,g/L, HCI was determined with 72.5% sensitivity, 74.2% specificity, 64.4% positive predict value and 80.7% negative predict value. Conclusion The detection of serum UCH- L1 level is helpful to the early identification of HCI, TIA and LACI.

关 键 词：超急性脑梗死 腔隙性脑梗死 短暂性脑缺血发作 泛素C末端水解酶-1 早期诊断 

分 类 号：R743.3[医药卫生—神经病学与精神病学]