IMA和CK指数在急性缺血性脑卒中的辅助诊断价值  

Auxiliary diagnostic value of IMA and CK index in acute ischemic stroke

作　　者：付毓平 付峰 朱亚 连甄帅 燕莎 李丹丹 贺志安 FU Yuping;FU Feng;ZHU Ya;LIAN Zhenshuai;YAN Sha;LI Dandan;HE Zhi′an(School of Medicine Laboratory,Sanquan College of Xinxiang Medical University,Xinxiang,Henan 453003,China;Zhengzhou Orthopedics Hospital,Zhengzhou,Henan 450003,China;Department of Clinical Laboratory,Henan Provincial People′s Hospital/Zhengzhou University People′s Hospital,Zhengzhou,Henan 450003,China;Center of Clinical Laboratory,Henan Provincial Hospital of Traditional Chinese Medicine/the Second Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan 450002,China;Department of Clinical Laboratory,Affiliated Taikang Xianlin Drum Tower Hospital,Medical School of Nanjing University,Nanjing,Jiangsu 210000,China)

机构地区：[1]新乡医学院三全学院医学检验学院,河南新乡453003 [2]郑州市骨科医院,河南郑州450003 [3]河南省人民医院/郑州大学人民医院检验科,河南郑州450003 [4]河南省中医院/河南中医药大学第二附属医院检验中心,河南郑州450002 [5]南京大学医学院附属泰康仙林鼓楼医院检验科,江苏南京210000

出　　处：《国际检验医学杂志》2024年第22期2716-2720,共5页International Journal of Laboratory Medicine

基　　金：河南省科技攻关项目(242102310292);南京市卫生科技发展专项资金资助项目(YKK22256)。

摘　　要：目的探讨缺血修饰白蛋白(IMA)和肌酸激酶(CK)指数在急性缺血性脑卒中(AIS)中的诊断价值。方法依据纳入和排除标准,纳入2021年10月至2022年10月在河南省人民医院住院的AIS患者149例作为AIS组。另选取同期健康体检者156例作为健康对照组。使用雅培C1600生化分析仪测量IMA、CK、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)和α-羟基丁酸脱氢酶(HBDH)的活性水平,计算CK指数(CK-MB与CK之比)。分析相对危险因素,构建受试者工作特征(ROC)曲线,使用SPSS 27.0.1进行数据分析,GraphPad Prism 9.4.1绘制图表,使用MedCalc(20.0.22版本)比较曲线下面积(AUC)的差异。结果AIS组IMA、CK-MB、CK指数显著高于健康对照组,CK水平显著低于健康对照组,差异有统计学意义(均P<0.05)。单因素Logistic回归分析显示IMA和CK指数都是AIS的危险因素(均P<0.001)。采用多因素二元Logistic回归分析调整性别和年龄后,IMA成为AIS的独立危险因素(OR=1.901,95%CI:1.649~2.190,P<0.001)。ROC曲线显示,单项检测IMA的AUC为0.922,灵敏度、特异度为81.2%、90.4%;与IMA+CK指数或IMA+CK指数+CK联合检测相比,差异无统计学意义(P>0.05)。结论IMA是AIS的独立危险因素,具有较强的诊断价值,值得临床推广应用。Objective To evaluate the diagnostic value of ischemia-modified albumin(IMA)and the creatine kinase(CK)index in acute ischemic stroke(AIS).Methods According to the inclusion and exclusion criteria,totally 149 newly diagnosed and untreated AIS patients hospitalized in Henan Provincial People′s Hospital from October 2021 to October 2022 were selected as the AIS group.Additionally,156 healthy people who underwent the physical examination during the same period were selected as the control group.Activity levels of IMA,CK,creatine kinase-MB(CK-MB),lactate dehydrogenase(LDH)and hydroxybutyrate-dehydrogenase(HBDH)were measured using the Abbott C1600 biochemical analyzer,and the CK index(ratio of CK-MB to CK)was calculated.Relative risk factors were analyzed,receiver operating characteristics(ROC)curve was constructed,data were analyzed using SPSS27.0.1,graphs were plotted using GraphPad Prism 9.4.1,and differences in area under the curve(AUC)were compared using MedCalc(version 20.0.22).Results The AIS group exhibited significantly higher levels of IMA,CK-MB,and the CK index,and significantly lower levels of CK compared to the control group(all P<0.05).Univariate logistic regression analysis revealed that both IMA and the CK index were risk factors for AIS(both P<0.001).After adjusting for gender and age in a multivariate binary logistic regression analysis,IMA emerged as an independent risk factor for AIS(OR=1.901,95%CI:1.649-2.190,P<0.001).IMA,CK-MB and CK index in the AIS group were significantly higher than those in the control group,and CK levels were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Univariate Logistic regression analysis showed that IMA and CK index were risk factors for AIS(P<0.001).After adjusting for sex and age in multivariate binary Logistic regression analysis,IMA was an independent risk factor for AIS(OR=1.901,95%CI:1.649-2.190,P<0.001).The ROC curve demonstrated that AUC,the sensitivity and the specificity of single detection f

关 键 词：缺血修饰白蛋白 肌酸激酶指数 急性缺血性脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]