血清Hcy、hs-CRP及抗β2糖蛋白1抗体、抗心磷脂抗体与脑梗死的关系  

Relationship between serum Hcy,hs-CRP,anti-β2 glycoprotein 1 antibody,anti-cardiolipin antibody and cerebral infarction

作　　者：陶晓明[1] 刘伟[2] 陈向华[1] 宗春光[1] 丁萌[1] 赵春楠 尤立扬[3] TAO Xiao-ming;LIU Wei;CHEN Xiang-hua;ZONG Chun-guang;DING Meng;ZHAO Chun-nan;YOU Li-yang(Department of Clinical Laboratory,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China;Department of Neurology,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China;Department of Physical Examination,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China)

机构地区：[1]承德医学院附属医院检验科,河北承德067000 [2]承德医学院附属医院神经内科,河北承德067000 [3]承德医学院附属医院体检科,河北承德067000

出　　处：《川北医学院学报》2022年第8期1004-1007,共4页Journal of North Sichuan Medical College

基　　金：河北省承德市科学技术研究与发展计划项目(201706A049)。

摘　　要：目的:探讨血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)及抗β2糖蛋白1抗体(aβ2-GP1)、抗心磷脂抗体(ACA)与脑梗死的关系。方法:选取192例脑梗死患者为研究对象,根据入院时美国国立卫生研究院脑卒中量表(NIHSS)评分分为轻度组(NIHSS评分<5分,n=103)、中度组(NIHSS评分=5~15分,n=57)和重度组(NIHSS评分≥16分,n=32);另选60名同期年龄、性别配对的体检健康志愿者为对照组。比较各组对象血清Hcy、hs-CRP及aβ2-GP1、ACA水平,受试者工作特征(ROC)曲线分析其诊断脑梗死的价值。结果:四组对象血清Hcy、hs-CRP及aβ2-GP1、ACA水平比较,差异有统计学意义(P<0.05),且重度组>中度组>轻度组>对照组(P<0.05);ROC曲线分析显示,血清Hcy、hs-CRP、aβ2-GP1、ACA的截断(Cut-off)值为9.72μmol/L、2.05 mg/L、14.28 RU/mL、8.93 RU/mL时,曲线下面积(AUC)分别为0.715、0.670、0.729、0.872,敏感度分别为77.60%、81.77%、83.85%、89.06%,特异度分别为53.33%、51.66%、61.67%、60.00%;联合检测的敏感度为94.27%,特异度为67.74%。联合检测诊断脑梗死的一致性较好。结论:血清Hcy、hs-CRP、aβ2-GP1、ACA水平与脑梗死的严重程度相关,在高风险人群脑梗死筛查中,aβ2-GP1、ACA的诊断价值高于Hcy、hs-CRP,四种指标联合检测可提高准确率。Objective:To study the relationship between serum homocysteine(Hcy),high-sensitivity C-reactive protein(hs-CRP),anti-β2 glycoprotein 1 antibody(aβ2-GP1),anti-cardiolipin antibody(ACA)and cerebral infarction.Methods:A total of 192 patients with cerebral infarction were selected as the research subjects.They were divided into mild group(NIHSS score<5 points)103 cases,moderate group(NIHSS score 5-15 points)57 cases,and severe group(NIHSS score≥16 points)32 cases according to the National Institutes of Health Stroke Scale(NIHSS)score at admission,another 60 healthy volunteers of the same age and sex were selected as the control group.The levels of serum Hcy,hs-CRP,aβ2-GP1,and ACA in each group were compared,and ROC curves were established to analyze the value of Hcy,hs-CRP,aβ2-GP1,and ACA levels in the diagnosis of cerebral infarction.Results:There were significant differences in the levels of serum Hcy,hs-CRP,aβ2-GP1 and ACA in the control group,mild group,moderate group and severe group(P<0.05).The levels of serum Hcy,hs-CRP,aβ2-GP1,and ACA in the severe group were higher than those in the control group,mild group,and moderate groups,the moderate group higher than the control group and mild group,the mild group were higher than the control group,and the differences were statistically significant(P<0.05).The ROC curve was established.When the Cut-off of serum Hcy,hs-CRP,aβ2-GP1,and ACA were 9.72μmol/L,2.05 mg/L,14.28 RU/mL and 8.93 RU/mL,AUC was 0.715,0.670,0.729 and 0.872,respectively,the sensitivity rates were 77.60%,81.77%,83.85%,89.06%,and the specificities were 53.33%,51.66%,61.67%,and 60.00%,respectively.The combined detection had a sensitivity of 94.27% and a specificity of 67.74%.The consistency of combined detection in diagnosing cerebral infarction was good.Conclusion:Serum Hcy,hs-CRP,aβ2-GP1,and ACA are related to the severity of cerebral infarction.In the screening of cerebral infarction in high-risk groups,the diagnostic value of aβ2-GP1 and ACA is higher than that of Hcy and hs-CRP.The comb

关 键 词：同型半胱氨酸 超敏C反应蛋白 抗Β2糖蛋白1抗体 抗心磷脂抗体 脑梗死 

分 类 号：R657.51[医药卫生—外科学]