联合检测血浆脂蛋白磷脂酶 A2、D-二聚体对高血压患者并发脑卒中的价值  

The clinical value of combined detection of plasma Lp -PLA2 and D -dimer in patients with hypertension complicated with stroke

作　　者：王琨[1] 赵长新[1] 张英[1] 杨伏猛[1] 姜建东[1] 曹金霞[1] 张廷禄 

机构地区：[1]连云港市第二人民医院检验科,江苏省连云港222002 [2]连云港市疾病控制中心应急办,江苏省连云港222002

出　　处：《中国基层医药》2017年第4期522-525,I0003,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：江苏省连云港市科技局医学检验科重点学科建设项目（SH1526）

摘　　要：目的：探讨血浆脂蛋白磷脂酶 A2（Lp-PLA2）和 D-二聚体联合检测对高血压患者并发脑卒中的预测价值。方法收集高血压合并脑卒中患者70例（A 组）、单纯高血压患者72例（B 组）、体检健康者71例（C 组），采用上转发光法检测血浆 Lp-PLA2，免疫比浊法检测血浆 D-二聚体，并分析两者单独及联合检测预测高血压并发脑卒中的价值。结果A 组血浆 Lp-PLA2、D-二聚体水平分别为（471．88±181．49）ng／mL、（982．54±373．28）μg／mL，B 组分别为（195．17±34．74）ng／mL、（263．57±29．70）μg／mL，C 组分别为（122．94±46．25）ng／mL、（96．44±8．49）μg／mL，三组差异有统计学意义（F ＝189．7、171．1，均 P ＝0．000）。A 组血浆Lp-PLA2水平与 D-二聚体呈正相关（r ＝0．692，P ＜0．01）；血浆 D-二聚体＞252μg／mL 预测高血压卒中风险的敏感度为83．3％、特异度为98．6％，血浆 Lp-PLA2＞176．36 ng／mL 预测高血压卒中风险的敏感度为92.9％、特异度为83．1％，两者联合预测高血压卒中风险的敏感度为87．6％、特异度为93．5％。结论高血压脑卒中患者血浆 Lp-PLA2、D-二聚体水平显著升高，两者联合检测可提高预测高血压患者并发脑卒中的风险。Objective To investigate the predictive value of plasma lipoprotein phospholipase A2 （Lp -PLA2 ）and D -dimer in patients with hypertension complicated with stroke.Methods 70 hypertensive patients with stroke were selected as A group,72 patients with simple hypertension were selected as B group,and 71 healthy sub-jects were selected as C group.The light transmitting method was used to detect serum Lp -PLA2 ,and immunoturbi-dimetry was used to detect plasma D -dimer.The clinical value of the two joint detection and single detection in prediction of hypertension complicated with stroke was analyzed.Results The plasma Lp -PLA2 and D -dimer levels of A group were （471.88 ±181.49）ng/mL,（982.54 ±373.28）μg/mL,which were higher than those of B group[（195.17 ±34.74）ng/mL,（263.57 ±29.70）μg/mL]and C group[（122.94 ±46.25）ng/mL,（96.44 ± 8.49）μg/mL]（F =189.7,171.1,all P =0.000）.The plasma Lp -PLA2 level of A group was positively correlated with D -dimer（r =0.692,P 〈0.01）.The plasma D -dimer 〉252g/mL forecast hypertension stroke risk sensitivity was 83.3% and specificity was 98.6%,the plasma Lp -PLA2 〉176.36ng/mL forecast hypertension stroke risk sen-sitivity was 92.9% and specificity was 83.1%,and the combined prediction of hypertension stroke risk sensitivity was＆nbsp;87.6%,specificity was 93.5%.Conclusion The plasma levels of Lp -PLA2 and D -dimer are significantly increased in hypertensive patients with stroke,and the combined detection of the two indicators can improve the prediction of stroke risk in patients with hypertension.

关 键 词：高血压 卒中 血浆脂蛋白磷脂酶 A2 D-二聚体 

分 类 号：R446.6[医药卫生—诊断学] R544.1[医药卫生—临床医学] R743.3