摘要
目的探究血浆脂蛋白相关磷脂酶A2(lipoprotein associated phospholipase A2,Lp-PLA2)、同型半胱氨酸(homocysteine,Hcy)水平与急性脑梗死(acute cerebral infarction,ACI)的关系。方法选取2016年5月-2018年8月我院ACI患者104例作为实验组,另选取同期68例健康体检者作为对照组。测定对比两组对象血浆Lp-PLA2、Hcy水平,实验组不同脑梗死面积、病情严重程度患者血浆Lp-PLA2、Hcy水平,分析血浆Lp-PLA2、Hcy水平和ACI患者神经功能缺损程度评分(National Institutes of Health Stroke Scale,NHISS)、脑梗死面积之间相关性,对比单独及联合应用血浆Lp-PLA2、Hcy水平检测诊断ACI的特异度、敏感度及准确度。结果实验组血浆Lp-PLA2、Hcy水平均高于对照组(P均<0.05);实验组不同脑梗死面积患者血浆Lp-PLA2、Hcy水平差异均有统计学意义(P均<0.05),且大面积梗死者血浆Lp-PLA2、Hcy水平高于中等和小面积梗死者,中等面积梗死者高于小面积梗死者(P均<0.05);实验组不同病情严重程度患者血浆Lp-PLA2、Hcy水平差异均有统计学意义(P均<0.05),且病情严重程度为重度者高于中度和轻度者,中度者高于轻度者(P均<0.05);相关性分析结果显示,血浆Lp-PLA2、Hcy水平和ACI患者的NHISS评分、脑梗死面积间呈正相关(P均<0.05);应用血浆Lp-PLA2、Hcy水平联合诊断ACI的敏感度88.46%、准确度85.47%均高于应用单一方法诊断(P均<0.05)。结论急性脑梗死患者血浆Lp-PLA2、Hcy水平增高,其水平与患者脑梗死面积、病情严重程度呈正相关,应用两指标联合检测可提升ACI诊断的敏感度与准确度,减少漏诊。
Objective To investigate the relationship between plasma lipoprotein-associated phospholipase A2(Lp-PLA2),homocysteine(Hcy)levels and acute cerebral infarction(ACI).Methods From May 2016 to August 2018,104 patients with ACI in our hospital were selected as the experimental group,and 68 healthy subjects in the same period were selected as the control group.Plasma Lp-PLA2 and Hcy levels were measured and compared between the two groups.Plasma Lp-PLA2 and Hcy levels were measured in patients with different cerebral infarction size and severity,and plasma Lp-PLA2,Hcy levels and ACI patients'neurological deficit scores were analyzed(National Institutes).The correlation between the health and cerebral infarction area,the specificity,sensitivity and accuracy of the diagnosis of ACI compared with the combined use of plasma Lp-PLA2 and Hcy levels.Results The plasma levels of Lp-PLA2 and Hcy in the experimental group were higher than those in the control group(P all<0.05);the plasma levels of Lp-PLA2 and Hcy in the patients with different cerebral infarction areas in the experimental group were significantly different(P all<0.05),and the plasma levels of Lp-PLA2 and Hcy in the patients with large area infarction were higher than those with medium and small area infarction,and those with medium area infarction were higher than those with small area infarction(P all<0.05).There were significant differences in plasma Lp-PLA2 and Hcy levels in patients with severity(P all<0.05),and the severity of the disease was higher in severe patients than that in moderate and mild patients(P all<0.05).The correlation analysis showed that plasma Lp-PLA2,Hcy levels were positively correlated with NHISS scores and cerebral infarction area in ACI patients(P all<0.05);plasma Lp-PLA2 and Hcy levels were positively correlated with cerebral infarction area in ACI patients(P all<0.05).The sensitivity and accuracy of plain combined diagnosis of ACI were 88.46%and 85.47%higher than that of single diagnosis(P all<0.05).Conclusion The level of plasma
作者
杨秦予
郭桂智
周美宁
YANG Qinyu;GUO Guizhi;ZHOU Meining(Department of Neurology,Shanxi Friendship Hospital,Xi'an 710068,China)
出处
《宁夏医科大学学报》
2019年第5期489-493,共5页
Journal of Ningxia Medical University
关键词
急性脑梗死
脂蛋白相关磷脂酶A2
同型半胱氨酸
病情严重程度
脑梗死面积
诊断效能
acute cerebral infarction
lipoprotein-associated phospholipase A2
homocysteine
severity of disease
area of cerebral infarction
diagnostic efficacy
