血清同型半胱氨酸、Tau蛋白和脂蛋白a在脑梗死中的监测价值  

The Value of Monitoring Serum Homocysteine,Tau Protein and Lipoprotein A Levels in Cerebral Infarction

作　　者：匡静[1] 王益 冯婷[1] 刘茂春 谭强 KUANG Jing;WANG Yi;FENG Ting;LIU Maochun;TAN Qiang(Department of Neurology,Guang’an People’s Hospital,Guang’an 638000,China)

机构地区：[1]广安市人民医院神经内科,四川广安638000

出　　处：《标记免疫分析与临床》2022年第2期316-320,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的研究血清同型半胱氨酸(Hcy)、Tau蛋白和脂蛋白a联合诊断脑梗死的监测价值。方法选取2018年1月至2020年1月在本院神经内科就诊的60例脑梗死患者为研究组,选取同时期在本院体检的60例健康者为对照组,统计其临床基本资料和常规体检指标,并采用ELISA实验测定血清Hcy、Tau蛋白和脂蛋白a水平,多因素Logistic回归分析脑梗死发病的危险因素。结果研究组患者的血清低密度脂蛋白、Hcy、Tau蛋白和脂蛋白a水平均明显高于对照组(P<0.05),Logistic回归分析表明Hcy(OR=3.467)、Tau蛋白(OR=3.647)以及脂蛋白a(OR=3.285)是脑梗死发病的主要危险因素。研究组患者的血清Hcy、Tau蛋白和脂蛋白a水平随着病情严重程度的加剧呈升高趋势,轻度、中度与重度之间的差异均有统计学意义(P<0.05)。预后良好组的血清Hcy、Tau蛋白和脂蛋白a水平明显低于预后不良组(P<0.05)。Hcy、Tau蛋白和脂蛋白a联合诊断脑梗死的AUC为0.896,最佳灵敏度和特异性分别为0.797、0.902;联合预测不良预后的AUC可以达到0.881,最佳灵敏度和特异性分别为0.875和0.795(P<0.05)。结论Hcy、Tau蛋白以及脂蛋白a水平可能是脑梗死的血清学标志物,对病情诊断及预后评估有一定的指导作用。Objective To investigate the value of monitoring serum homocysteine(Hcy),Tau protein and lipoprotein A levels in the diagnosis of cerebral infarction.Methods Sixty patients with cerebral infarction who were admitted to the Department of Neurology of our hospital from January,2018 to January,2020 were selected as the study group,while 60 healthy subjects who underwent physical examination in our hospital during the same period were selected as the control group.The basic clinical data and routine physical examination indexes were statistically analyzed.Serum Hcy,Tau protein and lipoprotein A levels were determined by ELISA assay,and the risk factors of cerebral infarction were analyzed by multivariate logistic regression.Results Serum low density lipoprotein,Hcy,Tau and lipoprotein A levels in the study group were significantly higher than those in the control group(P<0.05).Logistic regression analysis revealed that Hcy(OR=3.467),Tau protein(OR=3.647)and lipoprotein a(OR=3.285)were the risk factors of cerebral infarction.Serum levels of Hcy,Tau protein and lipoprotein A in the study group increased with the severity of the disease,and the differences among mild,moderate and severe were statistically significant(P<0.05).Serum levels of Hcy,Tau protein and lipoprotein A in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05).AUC of Hcy,Tau protein and lipoprotein A to diagnose cerebral infarction was 0.896,and the best sensitivity and specificity were 0.797 and 0.902,respectively.AUC of Hcy,Tau protein and lipoprotein A to predict poor prognosis was 0.881,and the best sensitivity and specificity were 0.875 and 0.795,respectively(P<0.05).Conclusion Hcy,Tau protein and lipoprotein A may serve as serological markers of cerebral infarction,and have a certain guiding role in the diagnosis and prognosis assessment of the disease.

关 键 词：同型半胱氨酸 TAU蛋白 脂蛋白A 脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]