外周血TMAO、CD62P对老年急性缺血性脑卒中患者预后的预测价值  

The Predictive Value of Peripheral Blood TMAO and CD62P on thePrognosis of Elderly Patients with Acute Ischemic Stroke

作　　者：赵小辉[1] 宋志军 杨晶 刘盼 耿彪[3] 王洪志 ZHAO Xiaohui;SONG Zhijun;YANG Jing;LIU Pan;GENG Biao;WANG Hongzhi(Emergency Department,Baoding Second Central Hospital,Baoding 072750 China;Emergency Department,People’s Hospital of Qingyuan District,Baoding 071100,China;Laboratory,Baoding Second Central Hospital,Baoding 072750 China)

机构地区：[1]保定市第二中心医院急诊科,河北保定072750 [2]保定市清苑区人民医院急诊科,河北保定071100 [3]保定市第二中心医院检验科,河北保定072750

出　　处：《标记免疫分析与临床》2021年第7期1217-1221,共5页Labeled Immunoassays and Clinical Medicine

基　　金：保定市科技计划自筹经费项目(编号:2041ZF225)。

摘　　要：目的探讨外周血氧化三甲胺(trimethylamine N-oxide,TMAO)与P-选择素(P-selectin,CD62P)联合诊断对老年急性缺血性脑卒中(accute ischemic stroke,AIS)患者预后的预测价值。方法选择2018年10月至2020年9月在我院收治的老年急性缺血性脑卒中患者124例为观察组,选取同一时间段内经本院体检正常的118例健康者为对照组。测定两组受试者血清中TMAO与CD62P水平,绘制ROC曲线并分析TMAO与CD62P联合检测对AIS的诊断价值。结果观察组血清中TMAO和CD62P水平显著高于对照组,差异具有统计学意义(P<0.05);TMAO和CD62P联合诊断的灵敏度为90.32%,高于二者单独检测时的灵敏度(79.03%、75.00%),且准确度(82.64%)也高于其他单一检测方法(79.34%、78.51%),同时有着良好的约登指数(0.649)。ROC曲线图显示,TMAO和CD62P联合诊断的ROC曲线下面积为0.866(95%CI:0.825~0.906),显著高于TMAO和CD62P单独检测,差异具有统计学意义(P<0.05)。结论外周血TMAO与CD62P联合诊断可显著提高老年缺血性脑卒中患者的诊断水平,为老年缺血性脑卒中患者的早期诊断和预后评估提供新的依据和思路。Objective To explore the predictive value of combined diagnosis of peripheral blood trimethylamine oxide(Trimethylamine N-oxide,TMAO)and P-selectin(P-selectin,CD62P)in the prognosis of elderly patients with acute ischemic stroke(accute ischemic stroke,AIS).Methods 124 elderly patients with acute ischemic stroke admitted to our hospital from October,2018 to September,2020 were selected as the observation group,while 118 healthy person who had undergone normal physical examinations in the hospital during the same time period were selected as the control group.We measured the serum levels of TMAO and CD62P in the two groups of patients,and drew ROC curve to analyze the diagnostic value of TMAO and CD62P combined detection for AIS.Results The serum levels of TMAO and CD62P in the observation group were significantly higher than those in the control group(P<0.05).The sensitivity of combined diagnosis of TMAO and CD62P was 90.32%,which was higher than the sensitivity of the single-marker test(79.03%,75.00%),and the accuracy(82.64%)was also higher than those of single detection methods(79.34%,78.51%),as well as a good Youden index(0.649).The ROC curve showed that the area under the ROC curve for the combined diagnosis of TMAO and CD62P was 0.866(95%CI:0.825-0.906),which was significantly higher than that of TMAO and CD62P alone(P<0.05).Conclusion The combined diagnosis of peripheral blood TMAO and CD62P can significantly improve the diagnostic performance of elderly patients with ischemic stroke,and provide a new reference for the early diagnosis and prognostic evaluation.

关 键 词：急性缺血性脑卒中 TMAO CD62P 诊断 

分 类 号：R743.3[医药卫生—神经病学与精神病学]