血清半胱氨酸、载脂蛋白、纤维蛋白原水平变化对脑梗死患者病情的影响  

The effects of changes of serum levels of Hcy,apolipoprotein and FIB on disease condition of patients with cerebral infarction

作　　者：匡静 冯婷 刘莉 KUANG Jing;FENG Ting;LIU Li(Department of Neurology,West China Guang'an Hospital,Sichuan University,Guang'an 638500,China)

机构地区：[1]四川大学华西广安医院神经内科,四川广安638500

出　　处：《实用医院临床杂志》2021年第1期148-151,共4页Practical Journal of Clinical Medicine

摘　　要：目的分析血清半胱氨酸(Hcy)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)、纤维蛋白原(FIB)水平变化对脑梗死患者病情的影响。方法我院收治的186例脑梗死患者为研究组,同期体检的健康志愿者55例为对照组,检测两组血清Hcy、ApoA、ApoB、FIB水平变化,分析与脑梗死病灶面积的关系,并采用受试者工作特征曲线(ROC)分析血清Hcy、ApoA、ApoB、FIB对脑梗死的诊断价值。结果治疗前,研究组血清Hcy、ApoB、FIB水平高于对照组,ApoA水平低于对照组(P<0.05),治疗后,两组血清Hcy、ApoA、ApoB、FIB水平比较,差异无统计学意义(P>0.05);脑梗死中、大面积组血清Hcy、ApoB、FIB水平高于小面积组,ApoA水平低于小面积组(P<0.05),大面积组血清Hcy、ApoB、FIB水平高于中面积组,ApoA水平低于中面积组(P<0.05);脑梗死患者血清Hcy、ApoB、FIB水平与NIHSS评分均呈正相关,ApoA与NIHSS评分均呈负相关(P<0.05);血清Hcy对脑梗死的诊断价值最高,AUC为0.925,以Hcy>12.09μmol/L为临界值,其诊断敏感度、特异度分别为93.50%、78.20%,ApoA、ApoB、FIB诊断脑梗死的AUC依次为0.784、0.813、0.833,分别以ApoA<1.34 g/L、ApoB>1.21 g/L、FIB>3.64 g/L为临界值,三者诊断敏感度依次为78.50%、71.50%、86.60%,特异度依次为69.10%、78.20%、70.90%。结论Hcy、ApoA、ApoB、FIB水平在脑梗死患者中异常升高,其水平随着脑梗死面积的增加而升高,各项指标联合检测对脑梗死的快速诊断和预测具有较高的临床价值。Objective To analyze the effects of changes of serum levels of homocysteine(Hcy),apolipoprotein A(ApoA),apolipoprotein B(ApoB)and fibrinogen(FIB)on disease condition of patients with cerebral infarction.Methods One hundred and eighty-six patients with cerebral infarction were selected as study subjects and 55 healthy volunteers who had physical examinations during the same period were selected as controls.Receiver operating characteristic curve(ROC)analysis was used to analyze the diagnostic value of these indexes for cerebral infarction.Results Before treatment,the levels of serum Hcy,ApoB and FIB were significantly higher while the ApoA level was significantly lower in the study group than those in the control group(P<0.05).There were no statistically significant differences in the levels of serum Hcy,ApoA,ApoB and FIB between the two groups after treatment(P>0.05).The levels of serum Hcy,ApoB and FIB of patients with middle-area and large-area cerebral infarction were significantly higher than those in patients with small-area cerebral infarction(P<0.05)while the level of ApoA was significantly lower than that in small-area cerebral infarction(P<0.05).The levels of Hcy,ApoB and FIB in patients with large-area cerebral infarction were significantly higher than those with middle-area cerebral infarction(P<0.05)while the level of ApoA was significantly lower than that in middle-area cerebral infarction(P<0.05).Correlation analysis showed that the levels of serum Hcy,ApoB and FIB of patients with cerebral infarction were positively correlated with NIHSS score(P<0.05),and ApoA was significantly negatively correlated with NIHSS score(P<0.05).Serum Hcy had the highest diagnostic value for cerebral infarction,and its AUC was 0.925 when Hcy>12.09μmol/L was taken as the critical value and the diagnostic sensitivity and specificity were 93.50%and 78.20%,respectively.The AUC values of ApoA,ApoB and FIB in the diagnosis of cerebral infarction were 0.784,0.813 and 0.833,respectively.When ApoA<1.34 g/L,ApoB>1.21 g/L and FIB

关 键 词：脑梗死 半胱氨酸 载脂蛋白A 载脂蛋白B 纤维蛋白原 

分 类 号：R743.3[医药卫生—神经病学与精神病学]