血清PMP、CD62P和β-TG水平在预测急性脑梗死预后的临床价值  

Clinical Value of Serum PMP,CD62P andβ-TG Levels in Predicting the Prognosis of Acute Cerebral Infarction

作　　者：汤卫忠 殷诺[2] 潘海滨[1] 翟大明[1] TANG Weizhong;YIN Nuo;PAN Haibin;ZHAI Daming(Department of Ultrasound,South Institute of the Sixth People′s Hospital Affiliated to Shanghai Jiaotong University/Shanghai Fengxian Central Hospital,Shanghai 201499,China;Department of Neurology,South Institute of the Sixth People′s Hospital Affiliated to Shanghai Jiaotong University/Shanghai Fengxian Central Hospital,Shanghai 201499,China)

机构地区：[1]上海交通大学附属第六人民医院南院/上海市奉贤中心医院超声科,上海201499 [2]上海交通大学附属第六人民医院南院/上海市奉贤中心医院神经内科,上海201499

出　　处：《中国医药导刊》2020年第4期231-236,共6页Chinese Journal of Medicinal Guide

摘　　要：目的:观察血清血小板微颗粒(PMP)、血小板ɑ-颗粒膜糖蛋白(CD62P)和β-血小板球蛋白(β-TG)在预测急性脑梗死预后的临床价值。方法:选择2017年1月至2018年6月在我院诊治的急性脑梗死患者126例,为急性脑梗死组。选择同期在我院行健康体检者45例,为健康对照组。采用酶联免疫吸附试验检测血清PMP、CD62P和β-TG。观察两组血清PMP、CD62P和β-TG水平,观察急性脑梗死患者血清PMP、CD62P和β-TG水平与颈部动脉斑块、脑梗死体积和预后不良的关系,及其预测预后不良发生的灵敏度和特异性。结果:急性脑梗死组血清PMP、CD62P和β-TG水平高于健康对照组(P<0.01)。急性脑梗死患者中,不稳定斑块组血清PMP、CD62P和β-TG水平高于稳定斑块组和无斑块组(P<0.01),而稳定斑块组血清PMP、CD62P和β-TG水平高于无斑块组(P<0.01)。急性脑梗死患者中,大体积梗死组血清PMP、CD62P和β-TG水平高于中体积梗死组和小体积梗死组(P<0.01),而中体积梗死组血清PMP、CD62P和β-TG水平高于小体积梗死组(P<0.01)。预后不良组血清PMP、CD62P和β-TG水平高于预后良好组(P<0.01)。急性脑梗死患者血清PMP、CD62P和β-TG水平在预测不良预后具有较高的灵敏度和特异性,联合检测在预测急性脑梗死不良预后具有更高的诊断效能,其灵敏度为80.6%,特异性为95.6%,其曲线下面积(AUC)高于单独检测PMP(Z=1.994,P<0.05)、CD62P(Z=2.802,P<0.01)和β-TG(Z=2.683,P<0.01)。结论:血清PMP、CD62P和β-TG参与了急性脑梗死的发生发展过程,其在预测不良预后方面具有较高的诊断效能,具有重要的临床价值。Objective:To observe the clinical value of platelet microparticles(PMP),plateletɑ-granular membrane glycoprotein(CD62P)andβ-thromboglobulin(β-TG)in predicting the prognosis of acute cerebral infarction.Methods:126 patients with acute cerebral infarction diagnosed and treated in our hospital from January 2017 to June 2018 were selected as acute cerebral infarction group.45 people who underwent health examinations in our hospital at the same period were selected as healthy control group.The serum PMP,CD62P andβ-TG levels were detected by enzyme-linked immunosorbent assay.The serum PMP,CD62P andβ-TG levels of the two groups were compared.The relations between the serum PMP,CD62P andβ-TG levels of patients with acute cerebral infarction and carotid artery plaque,cerebral infarction volume and poor prognosis were observed,and the sensitivity and specificity in predicting poor prognosis were analyzed.Results:The levels of serum PMP,CD62P andβ-TG in acute cerebral infarction group were higher than those in healthy control group(P<0.01).In patients with acute cerebral infarction,the levels of serum PMP,CD62P andβ-TG in unstable plaque group were higher than those in stable plaque group and non-plaque group(P<0.01),while the levels of serum PMP,CD62P andβ-TG in stable plaque group were higher than those in non-plaque group(P<0.01).The levels of serum PMP,CD62P andβ-TG in large volume cerebral infarction group were higher than those in medium volume infarction group and small volume infarction group(P<0.01),while the levels of serum PMP,CD62P andβ-TG in medium volume infarction group were higher than those in small volume infarction group(P<0.01).The serum PMP,CD62P andβ-TG levels in poor prognosis group were higher than those in good prognosis group(P<0.01).The serum PMP,CD62P andβ-TG levels in patients with acute cerebral infarction had high sensitivity and specificity in predicting poor prognosis,and combined detection had higher diagnostic efficacy in predicting poor prognosis of acute cerebral infarction.

关 键 词：血小板微颗粒 血小板α-颗粒膜糖蛋白 Β-血小板球蛋白 急性脑梗死 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]