血清前清蛋白和胆碱酯酶对脑卒中患者急性消化道出血的诊断价值  

Diagnostic value of serum prealbumin and cholinesterase for acute gastrointestinal bleeding in stroke patients

作　　者：黄双丽 林阳[1] 秦莲花[1] 钟洁平 HUANG Shuang-li;LIN Yang;QIN Lian-hua(Department of Neurology,West China Hospital,Sichuan University,Chengdu610041,China)

机构地区：[1]四川大学华西医院神经内科,四川成都610041

出　　处：《中国实验诊断学》2021年第9期1297-1300,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的分析血清前清蛋白(PA)和胆碱酯酶(ChE)对脑卒中患者急性消化道出血的诊断价值。方法选取2017年1月至2020年12月在四川大学华西医院进行治疗的脑卒中患者102例作为研究对象,根据是否发生急性消化道出血分为出血组(n=30例)和未出血组(n=72例),检测两组患者的PA、ChE水平及凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)等凝血相关指标,采用Spearman相关分析PA、ChE与凝血相关指标的关系,使用受试者工作特征曲线(ROC)评估PA、ChE水平在脑卒中患者急性消化道出血的诊断价值。结果出血组患者的PA、ChE水平明显低于未出血组(P<0.05);出血组患者的PT、APTT、TT水平明显高于未出血组(P<0.05),FIB水平明显低于未出血组(P<0.05);经Spearman相关分析结果显示,PA、ChE与PT、APTT、TT呈负相关(P<0.05),与FIB呈正相关(P<0.05);经ROC曲线分析结果显示,PA、ChE联合检测脑卒中患者急性消化道出血的诊断效能最大:AUC 0.885(95%CI 0.804-0.996),敏感度0.925,特异性0.767。结论PA、ChE与脑卒中患者急性消化道出血的发生、发展密切相关,有助于早期急性消化道出血的筛查,为临床治疗方案的制定提供参考。Objective To analyze the diagnostic value of serum prealbumin(PA)and cholinesterase(ChE)for acute gastrointestinal bleeding in stroke patients.Methods A total of 102 stroke patients treated in the hospital from January2017 to December 2020 were enrolled as the research objects.According to presence or absence of acute gastrointestinal bleeding,they were divided into bleeding group(n=30)and non-bleeding group(n=72).The levels of PA and ChE,prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)and thrombin time(TT)in both groups were detected.The relationship between PA,ChE and coagulation-related indexes was analyzed by spearman correlation analysis.The diagnostic value of PA and ChE levels for acute gastrointestinal bleeding in stroke patients was evaluated by receiver operating characteristic(ROC)curves.Results The levels of PA and ChE in bleeding group were significantly lower than those in non-bleeding group(P<0.05),levels of PT,APTT and TT were significantly higher than those in non-bleeding group(P<0.05),and FIB level was significantly lower than that in nonbleeding group(P<0.05).The results of spearman correlation analysis showed that PA and ChE were negatively correlated with PT,APTT and TT(P<0.05),while positively correlated with FIB(P<0.05).The results of ROC curve analysis showed that diagnostic efficiency of PA combined with ChE was the greatest for acute gastrointestinal bleeding in stroke patients[AUC0.885(95%CI 0.804-0.996),sensitivity 0.925,specificity 0.767].Conclusion PA and ChE are closely related to the occurrence and development of acute gastrointestinal bleeding in stroke patients,which are conductive to its early screening,and providing reference for formulation of clinical treatment plans.

关 键 词：血清前清蛋白 胆碱酯酶 脑卒中 急性消化道出血 诊断价值 

分 类 号：R743[医药卫生—神经病学与精神病学]