三项实验室指标联合预测急性脑梗死的价值  

Value of serum Hcy,Fib and blood lipids levels in predicting acute cerebral infarction

作　　者：刘磊[1] 杨兴东[1] 史冬梅[1] 冯浩[1] 张燕辉[1] 于逢春[1] Liu Lei;Yang Xingdong;Shi Dongmei;Feng Hao;Zhang Yanhui;Yu Fengchun(Department of Neurology,Beijing Haidian Hospital,Peking University No.3 Hospital,Beijing 100086,China)

机构地区：[1]北京市海淀医院,北京大学第三医院海淀院区神经内科,100086

出　　处：《中华老年心脑血管病杂志》2020年第7期744-747,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨同型半胱氨酸(Hcy)、纤维蛋白原(Fib)和血脂联合预测急性脑梗死的价值。方法选取2018年1~12月于我院收治的急性脑梗死患者90例为研究组,另外选择同期我院收治的79例非急性脑梗死患者为对照组,检测血清Hcy、Fib、血脂水平,用ROC曲线评估其诊断价值,比较Hcy和LDL及Fib三者联合与各项指标单独诊断急性脑梗死的准确性、敏感性、特异性、阴性预测值、阳性预测值。结果研究组Hcy、Fib、TC、LDL水平显著高于对照组,差异有统计学意义[(15.90±7.40)μmol/L vs(11.59±5.42)μmol/L,P<0.01;(3.38±0.87)g/L vs(2.95±0.62)g/L,P<0.01;(4.61±1.14)mmol/L vs(4.11±0.95)mmol/L,P<0.01;(2.98±0.94)mmol/L vs(2.47±0.75)mmol/L,P<0.01]。研究组Hcy、Fib、LDL阳性率明显高于对照组(P<0.01)。Hcy、Fib和LDL三者联合诊断的准确性、敏感性和阴性预测值较各项指标单独诊断更高(P<0.05)。结论急性脑梗死患者Hcy、Fib、LDL水平较高,且3项指标联合检测对急性脑梗死的诊断具有较高的阳性率。Objective To study the value of serum homocysteine(Hcy),fibrinogen(Fib)and blood lipids levels in predicting acute cerebral infarction(ACI).Methods Ninety ACI patients admitted to our hospital from January 2018 to December 2018 served as a study group with 79 ACI-free patients served as a control group.Their serum Hcy,Fib and blood lipids levels were measured.The value of serum Hcy,Fib and blood lipids levels in diagnosis of ACI was evaluated by ROC curve analysis.The accuracy,sensitivity,specificity,negative and positive predictive value of serum Hcy,LDL and Fib levels and their combination in diagnosis of ACI were compared.Results The serum levels of Hcy,Fib,TC and LDL were significantly higher in study group than in control group(15.90±7.40μmol/L vs 11.59±5.42μmol/L,P<0.01;3.38±0.87 g/L vs 2.95±0.62 g/L,P<0.01;4.61±1.14 mmol/L vs 4.11±0.95 mmol/L,P<0.01;2.98±0.94 mmol/L vs 2.47±0.75 mmol/L,P<0.01).The accuracy,sensitivity and negative predictive value of serum Hcy,Fib and LDL levels in diagnosis of ACI were significantly higher than those of serum Hcy level,serum Fib level and serum LDL level respectively in diagnosis of ACI(P<0.05).Conclusion The serum Hcy,Fib and LDL levels are rather high in ACI patients with a relatively high positive rate in diagnosis of ACI.

关 键 词：脑梗死 高半胱氨酸 纤维蛋白原 ROC曲线 血脂异常 高同种半胱氨酸血症 诊断 

分 类 号：R743.33[医药卫生—神经病学与精神病学]