摘要
目的观察脑卒中患者急性期血清人帕金森病蛋白7(PARK7)水平变化,探讨其对脑卒中早期诊断的临床意义。方法选择脑卒中患者65例,其中缺血性脑卒中37例(IS组)、出血性脑卒中28例(ICH组),同期门诊健康体检者30例作为对照组;采用酶联免疫吸附法检测对照组和两组患者发病12 h内及第3、14天血清PARK7,采用受试者工作特征曲线(ROC)评价其敏感度和特异度,分析其与改良爱丁堡—斯堪的纳维亚卒中评定量表评分(MESSS)、Barthel指数(BI)的关系。结果 IS组发病12 h内及第3、14天血清PARK7分别为(32.79±6.94)、(31.23±6.04)、(32.71±6.34)μg/L,ICH组分别为(31.61±5.06)、(32.05±4.29)、(31.48±5.94)μg/L,对照组为(14.25±2.65)μg/L。IS、ICH组各时点均高于对照组,P均<0.01;IS、ICH组同组不同时点间及两组同时点间比较,P均>0.05。采用ROC曲线,以20.256μg/L为界值,PARK7诊断IS的灵敏度为97.3%,特异度为96.7%,阳性似然比29.19,阴性似然比0.028,ROC曲线下面积0.995(P=0.000);诊断ICH的灵敏度为96.4%,特异度为96.7%,阳性似然比29.21,阴性似然比0.037,ROC曲线下面积=0.965(P=0.000)。IS组在12 h内血清PARK7水平与MESSS评分呈正相关(r=0.357,P<0.05),ICH组在发病第14天血清PARK7与BI呈负相关(r=-0.478,P<0.05),ICH组发病初期出血量与血清PARK7水平呈正相关(r=0.486,P=0.012)。结论脑卒中患者急性期血清PARK7水平升高,PARK7可以作为脑卒中早期诊断的生物标志物。
Objective To observe the changes of serum Parkinson protein 7 （ PARK7 ） level in acute stroke patients and to investigate its clinic significance in early diagnosis. Methods Sixty-five patients with stroke were selected, including 37 cases with ischemic stroke as IS group and 28 cases with intracerebral haemorrhage as ICH group, and 30 healthy people at the same period as the control group. ELISA was used to determine serum PARK7 level in the control group and two other groups within 12 h, on the third day and the fourteenth day after onset of stroke. The sensitivity and the specificity were evaluated by using the receiver-operating characteristic （ROC） curve and the correlation with MESSS, BI was analyzed. Results The serum PARK7 levels of IS group within 12h, on day 3 and 12 were （32.79 ± 6.94）, （31.23 ± 6.04） and （32.71 ±6.34 ）μg/L respectively, the levels of ICH group separately were （31.61 ± 5.06 ）, （32.05 ± 4.29）, （31.48 ± 5.94） μg/L, and the control group was （ 14.25 ± 2.65 ）μg/L. The levels of IS and ICH group were higher than the control group at each point （ P 〈 0.01 ）. Comparison between IS and ICH group in the same group at different time points and between the two groups at the same time all P 〉 0.05. Using the ROC curve, the boundary value of PARK7 was 20. 256 μg/L. In the IS group, the sensitivity and specificity were 97.3% and 96.7% , the positive likelihood ratio was 29.19, the negative likelihood ratio was 0.028, 0.995 the area under the ROC curve （P = 0. 000） ; in the ICH group, the sensitivity and specificity were 96.43% and 96.7% , the positive likelihood ratio was 29.21, the negative like- lihood ratio was 0.037, 0. 965 the area under the ROC curve （P =0.000）. The serum level of PARK7 had positive correlation with MESSS in the IS group within 12 h （ r = 0. 357, P 〈 0.05 ） ; the level had negative correlation with BI in the ICH group on day 12 （ r = - 0. 478, P 〈 0.05）, but the level had positive correlation with bleed
出处
《山东医药》
CAS
2013年第24期12-14,共3页
Shandong Medical Journal
基金
天津市科技成果奖项目(20100756)
