血清凝血酶抗凝血酶复合物、乳酸脱氢酶、降钙素原与脑梗死溶栓治疗效果的相关性及预测价值分析  

Correlation and predictive value analysis of serum antithrombin Ⅲ,lactate dehydrogenase and procalcitonin with the efficacy of thrombolytic therapy for cerebral infarction

作　　者：褚宁涵 王澎 赵舰 吕欣哲 吴丹蕾 左瑞菊 张林 CHU Ninghan;WANG Peng;ZHAO Jian(Clinical Medical Laboratory Center,Cangzhou People's Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市人民医院临床医学检验中心,061000 [2]沧州市人民医院神经外科,061000 [3]沧州市中心血站检验科

出　　处：《临床神经病学杂志》2024年第6期422-427,共6页Journal of Clinical Neurology

摘　　要：目的探讨血清凝血酶抗凝血酶复合物(TAT)、乳酸脱氢酶(LDH)、降钙素原(PCT)与脑梗死溶栓治疗效果的相关性及预测价值分析。方法选取2021年5月至2023年4月于本院就诊的140例脑梗死患者,所有患者接受静脉溶栓治疗并用NIHSS评估溶栓效果,根据溶栓效果分为效果不佳组、效果良好组;采集患者入院、治疗24 h和治疗5 d的空腹静脉血,用ELISA法检测血清TAT、LDH、PCT水平;用Pearson法及Spearman法分析治疗5 d效果不佳组血清TAT、LDH、PCT的相关性,以及三者分别与NIHSS减分率的相关性;采用ROC曲线分析血清TAT、LDH、PCT对溶栓效果不佳的诊断价值;使用Logistics回归分析影响溶栓效果不佳的因素。结果治疗后24 h和治疗后5 d脑梗死患者TAT、LDH、PCT水平较治疗前均显著降低,治疗后5 d脑梗死患者血清中TAT、LDH、PCT水平较治疗后24 h均显著降低(均P<0.05);与效果良好组相比,效果不佳组NIHSS减分率显著降低,血清TAT、LDH、PCT显著增加(均P<0.05)。效果不佳组血清TAT分别与LDH、PCT具有正相关性,血清LDH与PCT呈正相关。Spearman法分析显示,效果不佳组血清TAT、LDH、PCT分别与NIHSS减分率均呈负相关性。血清TAT、LDH、PCT以及三者联合诊断脑梗死溶栓治疗效果不佳的曲线下面积分别为0.863、0.833、0.833、0.919,三者联合优于各自单独诊断(Z=1.976,Z=3.365,Z=2.946;P=0.048,P=0.000,P=0.003);血清TAT、LDH、PCT、NIHSS减分率为脑梗死溶栓治疗效果不佳的独立影响因素(均P<0.05)。结论血清TAT、LDH、PCT高表达可能与脑梗死溶栓治疗效果不佳有一定的关系,并对溶栓治疗效果具有一定的预测价值,三者联合诊断效能增加。Objective To explore the correlation and predictive value of serum antithrombinⅢ(TAT),lactate dehydrogenase(LDH),procalcitonin(PCT)with the efficacy of thrombolytic therapy for cerebral infarction.Methods A total of 140 patients with cerebral infarction who visited our hospital from May 2021 to April 2023 were collected.All patients received intravenous thrombolysis treatment,and the thrombolysis effect was evaluated by the NIHSS.Based on the thrombolysis effect,the patients were grouped into the poor thrombolysis effect group and the good thrombolysis effect group.Fasting venous blood was collected from patients at admission,24 h of treatment and 5 d of treatment,and serum levels of TAT,LDH,and PCT were detected by ELISA.Pearson and Spearman methods were applied to analyze the correlation between serum TAT,LDH and PCT in patients at 5 d after treatment with poor thrombolysis efficacy,and the correlation between the three items and the NIHSS score reduction rate,respectively.ROC curve was applied to analyze the diagnostic value of serum TAT,LDH,and PCT for poor thrombolysis efficacy.Logistic regression was applied to analyze the factors that affected the poor thrombolysis effect.Results Serum levels of TAT,LDH,and PCT were significantly lower in patients with cerebral infarction at 24 h and 5 d after treatment compared with patients before treatment,and serum levels of TAT,LDH,and PCT were significantly lower in patients with cerebral infarction at 5 d after treatment compared with patients at 24 h after treatment(all P<0.05).Compared with those in the good thrombolysis effect group,the NIHSS score reduction rate was obviously reduced in the poor thrombolysis effect group,and serum TAT,LDH,and PCT were obviously increased(all P<0.05).The serum TAT in the poor thrombolysis effect group showed a positive correlation with LDH and PCT,while the serum LDH and PCT showed a positive correlation.Spearman analysis showed that there was a negative correlation between serum TAT,LDH,PCT,and NIHSS score reduction rate in pa

关 键 词：脑梗死 凝血酶抗凝血酶复合物 乳酸脱氢酶 降钙素原 溶栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]