血清GFAP、Hcy水平与急性缺血性脑卒中的相关性研究  

Correlation study between serum GFAP,Hcy levels and acute ischemic stroke

作　　者：凌小婷 王承翰 翟宁能 廖林[1] 林发全[1] LING Xiaoting;WANG Chenghan;ZHAI Ningneng;LIAO Lin;LIN Faquan(Department of Clinical Laboratory,the First Affiliated Hospital of Guangxi Medical University/Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education,Nanning,Guangxi 530021,China)

机构地区：[1]广西医科大学第一附属医院检验科/广西高校临床检验诊断学重点实验室,广西南宁530021

出　　处：《检验医学与临床》2023年第23期3496-3500,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨急性缺血性脑卒中(AIS)患者血清胶质纤维酸性蛋白(GFAP)和同型半胱氨酸(Hcy)水平与病情严重程度的相关性。方法选取该院2022年1月至2023年2月收治的AIS患者110例作为观察组,另选取该院同期健康体检者59例作为对照组,比较观察组和对照组白细胞计数(WBC)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、血清GFAP与Hcy水平;根据美国国立卫生院研究卒中量表(NIHSS)评分将110例AIS患者分为轻型组(73例)、中型组(32例)和重型组(5例),比较轻型组、中型组、重型组及不同住院时间患者的血清GFAP和Hcy水平,采用Spearman相关分析GFAP、Hcy与AIS患者NIHSS评分、住院总时间及WBC的相关性;构建受试者工作特征(ROC)曲线分析GFAP、Hcy单独及2项指标联合检测AIS的诊断价值。结果观察组患者的TC水平、WBC高于对照组,HDL-C水平低于对照组,差异均有统计学意义(P<0.05);观察组血清GFAP、Hcy水平高于对照组(P<0.05);中型组患者GFAP、Hcy水平高于轻型组,重型组高于中型组和轻型组,差异均有统计学意义(P<0.05);住院时间在8~14 d患者的GFAP水平高于住院时间<8 d的患者,住院时间>14 d患者的GFAP水平高于住院时间<8 d的患者,差异均有统计学意义(P<0.05)。Spearman相关分析结果显示,血清GFAP与Hcy呈正相关(r=0.253,P=0.001),GFAP水平与NIHSS评分、住院时间、WBC均呈现正相关(r=0.238、0.300、0.226,P<0.05),Hcy水平与NIHSS评分、WBC呈正相关(r=0.342、0.274,P<0.05)。ROC曲线分析结果显示,GFAP、Hcy单独用于诊断AIS的AUC分别为0.816、0.712,二者联合检测的AUC为0.857。结论AIS患者血清GFAP、Hcy水平均显著升高,且与AIS患者病情严重程度呈正相关,可用作临床AIS早期检测和评估病情严重程度的有效指标,具有一定临床参考价值。Objective To investigate the correlation of serum glial fibrillary acidic protein(GFAP)and homocysteine(Hcy)in patients with the severity of acute ischemic stroke(AIS).Methods A total of 110 patients with AIS admitted to this hospital from January 2022 to February 2023 were selected as the observation group,and 59 healthy physical examiners in this hospital were selected as the control group during the same period.The white blood cell count(WBC),total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),serum GFAP and Hcy levels between the observation group and the control group were compared.According to the National Institutes of Health Research Stroke Scale(NIHSS)score,110 patients with AIS were divided into mild group(73 cases),moderate group(32 cases)and severe group(5 cases).The levels of serum GFAP and Hcy in mild group,moderate group and severe group were compared and their correlation with the NIHSS score,hospital stay and WBC in patients with AIS was analyzed.The receiver operating characteristic(ROC)curve was constructed to analyze the diagnostic value of GFAP and Hcy alone and the combination of the two indexes in AIS.Results The TC level and WBC of the observation group were higher than those of the control group,and the HDL-C level was lower than that of the control group,and the differences were statistically significant(P<0.05).The levels of serum GFAP and Hcy in the observation group were higher than those in the control group(P<0.05).The levels of GFAP and Hcy in the moderate group were higher than those in the mild group(P<0.05),and the GFAP and Hcy levels in the severe group were higher than those in the moderate group and the mild group(P<0.05).The level of GFAP in patients with hospital stay of 8-14 d was higher than that in patients with hospital stay of<8 d,and the level of GFAP in patients with hospital stay of>14 d was higher than that in patients with hospital stay of<8 d,and the differences were statistically significant(P<0.05).Spea

关 键 词：急性缺血性脑卒中 胶质纤维酸性蛋白 同型半胱氨酸 相关性 

分 类 号：R446.11[医药卫生—诊断学]