流式细胞术检测在脑梗死后精神病性障碍患者中的诊断价值  

Diagnostic value of flow cytometry in patients with psychotic disorders after cerebral infarction

作　　者：田秀丽[1] 梁燕华[2] 张娟芝[1] 马秀莲 Tian Xiuli;Liang Yanhua;Zhang Juanzhi;Ma Xiulian(Neurology Department 2,Baoji Second People's Hospital,Baoji,Shaanxi,721000,China;Vasculocardiology Department 1,Baoji Second People's Hospital,Baoji,Shaanxi,721000,China)

机构地区：[1]陕西省宝鸡市第二人民医院神经内二科,陕西宝鸡721000 [2]陕西省宝鸡市第二人民医院心血管内一科,陕西宝鸡721000

出　　处：《西南国防医药》2021年第5期415-418,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨流式细胞术检测脑脊液CD4^(+)T细胞比例在脑梗死后精神病性障碍患者中的诊断价值。方法选取2018年6月~2021年1月医院收治的172例脑梗死患者作为研究对象,按照有无精神病性障碍分为研究组(有精神病性障碍者,60例)和对照组(无精神病性障碍者112例)。比较两组NIHSS评分、血常规、血液生化等常规指标。检测脑脊液S100B蛋白与神经元特异性烯醇化酶(neuron-specific enolase,NSE)含量,应用流式细胞术检测脑脊液CD4^(+)T细胞比例,采用多因素Logistic回归分析相关影响因素,绘制受试者工作特征曲线(ROC曲线)并分析各项指标的诊断价值。结果两组间NHISS评分、收缩压、舒张压、白细胞、血小板、凝血酶原时间、总胆红素、谷丙转氨酶、天冬氨酸转氨酶、白蛋白和性别、年龄、体重指数、梗死部位等常规指标比较,无统计学差异(P>0.05)。与对照组比较,研究组脑脊液S100B、NSE含量均明显升高,CD4^(+)T细胞比例明显降低(P<0.05)。多因素Logistic回归分析显示脑脊液S100B、NSE、CD4^(+)T细胞比例是导致脑梗死后精神病性障碍发生的重要影响因素(P<0.05);ROC曲线分析显示,脑脊液S100B、NSE、CD4^(+)T细胞比例在诊断脑梗死后精神病性障碍的曲线下面积分别为0.733、0.714、0.814,灵敏度为68.43%、70.39%、74.27%,特异度为83.72%、77.38%、80.31%。结论表达升高的脑脊液S100B、NSE含量和显著降低的CD4^(+)T细胞比例可能是脑梗死后精神病性障碍的诊断依据。在脑梗死后精神病性障碍患者的临床诊断中,流式细胞术检测脑脊液CD4^(+)T细胞比例具有重要诊断价值。Objective To explore the diagnostic values of flow cytometry for detection of CD4^(+)T cell proportion of cerebrospinal fluid in patients with psychotic disorders after cerebral infarction.Methods A total of 172 patients with cerebral infarction admitted to our hospital from June 2018 to January 2021 were selected and divided into the research group(n=60,with psychotic disorders)and the control group(n=112,without psychotic disorders)according to the presence or absence of psychotic disorders.NHISS score,blood routine and blood biochemical indexes were compared between the two groups.The contents of S100 B protein and neuron-specific enolase(NSE)in cerebrospinal fluid were measured.The proportion of CD4^(+)T cells in cerebrospinal fluid was measured by flow cytometry.The related influencing factors were analyzed by multivariate logistic regression.The receiver operating characteristic curve(ROC curve)was drawn,and the diagnostic value of each index was analyzed.Results The comparison of NHISS score,systolic blood pressure,diastolic blood pressure,white blood cells,platelets,prothrombin time,total bilirubin,alanine aminotransferase,aspartate aminotransferase,albumin,gender,age,body mass index and infarct position showed no statistically significant difference between the two groups(P>0.05).Compared with the control group,the contents of S100 B and NSE in cerebrospinal fluid of the study group significantly increased(P<0.05),and the proportion of CD4^(+)T cells significantly decreased(P<0.05).Multivariate logistic regression analysis showed that S100 B,NSE and proportion of cerebrospinal fluid were important factors in the development of psychotic disorders after cerebral infarction(P<0.05).ROC curve results showed that the area under the curve of the S100 B,NSE,and proportion of CD4^(+)T cells in cerebrospinal fluid in the diagnosis of psychotic disorders after infarction was0.733,0.714 and 0.814,respectively,sensitivity was 68.43%,70.39%and 74.27%respectively,and specificity was 83.72%,77.38%and 80.31%.Conclusion

关 键 词：脑梗死 精神病性障碍 流式细胞术 CD4^(+)T细胞比例 

分 类 号：R749.13[医药卫生—神经病学与精神病学]