Lp-PLA2、hs-CRP和FIB联合检测在急性脑梗死诊断中的应用

The Application of Combined Detection of PLA2,Hs-CRP and FIB in the Diagnosis of Acute Cerebral Infarction

目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)和纤维蛋白原(FIB)联合检测在急性脑梗死诊断中的临床价值。方法收集我院240例急性脑梗死的住院患者作为研究对象(脑梗组),以100例门诊体检健康人员为对照组,比较两组人群的一般临床数据及检验结果,记录患者入院时的NIHSS评分。分析急性脑梗死患者血浆Lp-PLA2、hs-CRP和FIB水平与其神经功能缺损程度的关系,进行多因素Logistic回归分析确定急性脑梗死的危险因素,利用ROC曲线评估患者血浆Lp-PLA2、hs-CRP和FIB水平对急性脑梗死的诊断价值。结果重度脑梗死患者的Lp-PLA2、hs-CRP和FIB水平均高于轻度及中度脑梗死患者(P<0.05);与对照组比较,脑梗组患者的血浆Lp-PLA2、hs-CRP和FIB水平均显著升高,差异均具有统计学意义(P<0.05)。血浆Lp-PLA2、hs-CRP和FIB水平与急性脑梗死发病风险显著相关(P<0.05)。Lp-PLA2、hs-CRP和FIB 3个指标中,Lp-PLA2的ROC曲线下面积最大,诊断价值最高;Lp-PLA2、hs-CRP和FIB联合检测能显著提高急性脑梗死的诊断效率。结论联合检测Lp-PLA2、hs-CRP和FIB对判断ACI患者神经功能缺损程度具有较高价值。

Objective To explore the clinical values of combined detection of lipoprotein-associated phospholipase A2(Lp-PLA2),high-sensitivity C-reactive protein(hs-CRP)and plasma fibrinogen(FIB)in the diagnosis of acute cerebral infarction(ACI).Methods A total of 240 inpatient who were diagnosed with ACI were selected as the research objects(cerebral infarction group),while 100 healthy people were selected as the control group.The general clinical data and the detection indicators between these two groups were compared;NIHSS scores in the cerebral infarction group were assessed.The relationship between levels of plasma Lp-PLA2,hs-CRP and FIB and the degree of neurological deficit in patients with ACI was analyzed,and the risk factors of ACI were determined by multivariate logistic regression analysis.In addition,the diagnostic value of Lp-PLA2,hs-CRP and FIB for ACI was evaluated by calculating the areas under the ROC curves(AUC).Results Levels of Lp-PLA2,hs-CRP and FIB in patients plasma with severe cerebral infarction were higher than those in patients with mild and moderate cerebral infarction(P<0.05).Compared with the control group,the plasma levels of Lp-PLA2,hs-CRP and FIB in patients with cerebral infarction were significantly higher(P<0.05).Levels of Lp-PLA2,hs-CRP and FIB were significantly correlated with the risk of ACI(P<0.05).Among the three indexes of Lp-PLA2,hs-CRP and FIB,Lp-PLA2 had the biggest area under the ROC curve and the highest diagnostic value.The combination of Lp-PLA2,hs-CRP and FIB could significantly improve the diagnostic efficiency of ACI.Conclusion There is a high clinical value of the combined detection of Lp-PLA2,hs-CRP and FIB in the diagnosis of the degree of neurological deficit in patients with ACI.