D-二聚体联合超敏C-反应蛋白在急性高血压脑出血患者中的应用  

Application of D-dimer combined with hypersensitive C-reactive protein in patients with acute hypertensive intracerebral hemorrhage

作　　者：杨婷婷[1] Yang Tingting(Department of Clinical Laboratory,Bayannur Hospital,Bayannur 015000,Inner Mongolia Autonomous Region,China)

机构地区：[1]巴彦淖尔市医院检验科,内蒙古自治区巴彦淖尔015000

出　　处：《实用检验医师杂志》2022年第2期178-181,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的探讨D-二聚体联合超敏C-反应蛋白(hs-CRP)在急性高血压脑出血患者中的应用效果及治疗指导价值。方法选择2019年5月—2021年12月巴彦淖尔市医院收治的78例急性高血压脑出血患者作为观察组,所有患者均给予常规方法治疗,根据预后分为存活组与死亡组;另外选择同期63名健康体检者作为对照组。D-二聚体水平采用全自动凝血分析仪进行检测,采用免疫比浊法测定hs-CRP,比较各组上述指标的差异。采用多因素Logistics回归分析方法考察急性高血压脑出血患者预后的可能影响因素;绘制受试者工作特征曲线(ROC曲线)并计算ROC曲线下面积(AUC),分析D-二聚体、hs-CRP在急性高血压脑出血患者治疗中的知道指导价值。结果观察组患者D-二聚体、hs-CRP水平均明显高于对照组〔D-二聚体(mg/L):18.24±2.15比0.28±0.06,hs-CRP(mg/L):23.15±2.63比4.31±0.27,均P<0.05〕。经治疗后,78例急性高血压脑出血患者中有31例死亡,病死率为39.74%。死亡组患者D-二聚体、hs-CRP水平均明显高于存活组〔D-二聚体(mg/L):24.61±3.69比14.32±2.01,hs-CRP(mg/L):29.58±5.32比15.68±1.69,均P<0.05〕。多因素Logistics回归分析结果表明,高D-二聚体表达〔优势比(OR)=3.583,95%可信区间(95%CI)为2.481~6.314〕、高hs-CRP表达(OR=6.414,95%CI为5.682~8.453)、颅内感染(OR=4.083,95%CI为3.234~4.573)、持续昏迷时间长(OR=1.034,95%CI为0.283~4.387)均为高血压脑出血患者预后的独立危险因素(均P<0.05)。ROC曲线表明,D-二聚体与hs-CRP联合检测对指导急性高血压脑出血患者治疗的AUC为0.846(95%CI为0.768~0.906),敏感度与特异度均高于D-二聚体、hs-CRP单独检测。结论D-二聚体和hs-CRP在急性高血压脑出血患者中呈高表达,是预后的独立危险因素,且二者联合检测能提高患者治疗指导的敏感度与特异度。Objective To investigate the application effect of D-dimer combined with hypersensitive C-reactive protein(hs-CRP)in patients with acute hypertensive intracerebral hemorrhage and its therapeutic guid value.Methods The 78 patients with acute hypertensive intracerebral hemorrhage admitted in Bayannur Hospital from May 2019 to December 2021 were selected as the observation group.All patients received conventional treatment and were divided into survival group and death group according to prognosis.Sixty-three healthy subjects were selected as the control group.Automatic coagulation analyzer was used to determine the level of D-dimer in each group.The level of hs-CRP was determined by immunoturbidimetry.Multiple Logistics regression analysis was performed on the possible influencing factors of prognosis in patients with acute hypertensive intracerebral hemorrhage.The receiver operator characteristic(ROC)curve was drawn and the area under ROC curve(AUC)was calculated to analyze the guiding value of D-dimer and hs-CRP in the treatment of patients with acute hypertensive intracerebral hemorrhage.Results The D-dimer and hs-CRP levels in observation group were higher than those in control group[D-dimer(mg/L):18.24±2.15 vs.0.28±0.06,hs-CRP(mg/L):23.15±2.63 vs.4.31±0.27,both P<0.05].There were 31 of 78 patients with acute hypertensive cerebral hemorrhage dead after treatment,and the fatality rate was 39.74%.The levels of D-dimer and hs-CRP in death group were higher than those in survival group[D-dimer(mg/L):24.61±3.69 vs.14.32±2.01,hs-CRP(mg/L):29.58±5.32 vs.15.68±1.69,both P<0.05].Multivariate Logistics regression analysis showed that high D-dimer expression[odds ratio(OR)=3.583,95%confidence interval(95%CI)was 2.481-6.314],high hs-CRP expression(OR=6.414,95%CI was 5.682-8.453),intracranial infection(OR=4.083,95%CI was 3.234-4.573)and prolonged coma(OR=1.034,95%CI was0.283-4.387)were independent risk factors for prognosis of patient with hypertensive intracerebral hemorrhage(all P<0.05).The ROC curve showed that t

关 键 词：D-二聚体 超敏C-反应蛋白 急性高血压脑出血 受试者工作特征曲线 

分 类 号：R743.34[医药卫生—神经病学与精神病学]