氧化三甲胺和血清淀粉样蛋白A在慢性脑缺血诊断中的价值  

Trimethylamine oxide and serum amyloid A in diagnosis of chronic cerebral hypoperfusion

作　　者：章鑫 张静[2,4] 成旭东[1,2] 张琦 周森 贾丽君[1,2] 王莉蓉 余能伟 ZHANG Xin;ZHANG Jing;CHENG Xudong;ZHANG Qi;ZHOU Sen;JIA Lijun;WANG Lirong;YU Nengwei(Department of Neurology,School of Clinical Medicine,Southwest Medical University,Luzhou,Sichuan 646000,China;不详)

机构地区：[1]西南医科大学临床医学院神经内科,四川泸州646000 [2]四川省医学科学院·四川省人民医院神经内科,四川成都610072 [3]西南医科大学附属成都三六三医院神经内科,四川成都610041 [4]电子科技大学临床医学院神经内科,四川成都610054

出　　处：《中国临床研究》2023年第8期1170-1174,共5页Chinese Journal of Clinical Research

基　　金：四川省科技厅项目(2021YFS0074);成都市科技局重大科技应用示范项目(2019-YF09-00142-SN)。

摘　　要：目的探讨外周血中氧化三甲胺(TMAO)、血清淀粉样蛋白A(SAA)水平对慢性脑缺血(CCH)的诊断价值。方法纳入2022年2月至6月在四川省人民医院神经内科就诊的患者,根据核磁共振动脉自旋标记(ASL)检查结果分为CCH组(55例)和对照组(42例)。采用ELISA法检测两组外周血中TMAO和SAA的表达量,采用ROC曲线分析其对CCH的诊断价值。结果CCH组TMAO和SAA表达量高于对照组(47.24±8.84 vs 40.81±8.33,t=3.639,P<0.05;14.04±2.70 vs 12.20±2.30,t=3.542,P<0.05)。TMAO、SAA高表达,有原发性高血压病是CCH发生的独立危险因素(P<0.05)。TMAO和SAA单独诊断CCH的ROC曲线下面积(AUC)分别为0.701(95%CI:0.594~0.809)和0.675(95%CI:0.565~0.786),两者联合检测诊断的AUC最高,为0.765(95%CI:0.667~0.863)。结论外周血TMAO和SAA与CCH的发生有关,可作为CCH的辅助诊断指标。Objective To investigate the diagnostic value of trimethylamine N-Oxide(TMAO)and serum amyloid A(SAA)levels in peripheral blood of patients with chronic cerebral hypoperfusion(CCH).Methods The patients attending the Department of Neurology of Sichuan Provincial People's Hospital from February 2022 to June 2022 were divided into CCH group(n=55)and control group(n=42)based on the results of magnetic resonance arterial spin labeling(ASL).The levels of TMAO and SAA were detected by ELISA and their diagnostic value for CCH were anaylzed by ROC curve.Results The levels of TMAO(47.24±8.84 vs 40.81±8.33,t=3.639,P<0.05)and SAA(14.04±2.70 vs 12.20±2.30,t=3.542,P<0.05)in CCH group were significantly higher than those in control group.High levels of TMAO and SAA and history of primary hypertension were independent risk factors for the occurrence of CCH(P<0.05).The areas under ROC curve(AUC)of TMAO and SAA for diagnosing CCH were 0.701(95%CI:0.594-0.809)respectively and 0.675(95%CI:0.565-0.786).The combined detection of TMAO and SAA achieved the highest AUC of 0.765(95%CI:0.667-0.863).Conclusion Both TMAO and SAA are related to the occurrence of CCH and can be used as auxiliary diagnostic indicators for CCH.

关 键 词：慢性脑缺血 氧化三甲胺 血清淀粉样蛋白A 动脉自旋标记技术 

分 类 号：R743.1[医药卫生—神经病学与精神病学]