D-D、MMP-9及Lp-PLA2联合检测用于脑梗死诊断的敏感度与特异性分析  

The analysis of D-D,MMP-9 and Lp-PLA2 joint detection for the sensitivity and specificity of diagnosis of cerebral infarction

作　　者：郭俊勇[1] GUO Jun-yong(The Red Cross Blood Center of Henan Province,Zhengzhou 450012,China)

机构地区：[1]河南省红十字血液中心,河南郑州450012

出　　处：《东南大学学报（医学版）》2018年第2期277-281,共5页Journal of Southeast University(Medical Science Edition)

基　　金：河南郑州"FNHTR及TRALI发病机制及预防干预研究"资助项目(134300510068)

摘　　要：目的:探讨血浆D-二聚体(D-D)、基质金属蛋白酶-9(MMP-9)、脂蛋白相关磷脂酶A2(Lp-PLA2)联合检测用于脑梗死诊断的敏感度与特异性分析。方法:将2014年3月至2016年5月在我院确诊的64例脑梗死患者纳入观察组,并选同期64例健康体检者纳入对照组,比较D-D、MMP-9、Lp-PLA2在两组受试者中的表达水平差异,并与受试者的美国国立卫生院神经功能缺损评分(NIHSS)进行相关性分析,采用受试者工作特征曲线(ROC)分析单独诊断、联合诊断敏感度及特异性。结果:观察组与对照组在D-D[(779.1±163.5)μg·L^(-1)vs(117.3±52.5)μg·L^(-1)]、MMP-9[(264.4±35.8)μg·L^(-1)vs(55.3±7.6)μg·L^(-1)]、Lp-PLA2[(28.7±10.2)nmol·L^(-1)vs(11.9±6.4)nmol·L^(-1)]表达水平上差异具有统计学意义(P<0.05),NIHSS与D-D(r=0.462)、MMP-9(r=0.493)、Lp-PLA2(r=0.592)均存在相关性,D-D、MMP-9、Lp-PLA2三者联用的敏感度(90.6%)、特异性(86.7%)、约登指数(0.77)及曲线下面积(0.898)均高于单独指标或两两指标联用。结论:D-D、MMP-9及Lp-PLA2联合检测有利于提高脑梗死诊断的准确度。Objective:To investigate the sensitivity and specificity of plasma D-dimer(D-D),matrix metalloproteinase-9(MMP-9)and lipoprotein-related phospholipase A2(Lp-PLA2)in the diagnosis of cerebral infarction.Methods:64 patients with cerebral infarction diagnosed in our hospital from March 2014 to May 2016 were enrolled in the observation group and 64 healthy subjects were included in the control group.The expression levels of DD,MMP-9 and Lp-PLA2 in the two groups of subjects were compared,and the relationships between the expression of DD,MMP-9,Lp-PLA2 and the NIHSS were analyzed and the sensitivity and specificity of individual diagnosis,combined diagnosis were analyzed by the use of the patient s characteristic curve(ROC).Results:There were significant differences between the observation group and the control group in the expression levels of DD[(779.1±163.5)μg·L-1 vs(117.3±52.5)μg·L-1],MMP-9[(264.4±35.8)μg·L-1 vs(55.3±7.6)μg·L-1]and Lp-PLA2[(28.7±10.2)nmol·L-1 vs(11.9±6.4)nmol·L-1].There was a correlation between NIHSS and D-D(r=0.462),MMP-9(r=0.493)and Lp-PLA2(r=0.592).The sensitivity(90.6%),specificity(86.7%),Jorden index(0.77)and area under the curve(0.898)of the three joint diagnosis were higher than those of the individual index or the two indicators.Conclusion:D-D,MMP-9 and Lp-PLA2 joint detection can improve the accuracy of cerebral infarction diagnosis.

关 键 词：脑梗死 D-二聚体 基质金属蛋白酶-9 脂蛋白相关磷脂酶A2 

分 类 号：R743.33[医药卫生—神经病学与精神病学]