六项蛋白指标联合检测对早期诊断脑梗死的价值

The value of combined detection of six proteins in the early diagnosis of cerebral infarction

目的分析6项蛋白指标联合检测对早期诊断脑梗死的临床价值。方法选择72 h内急性脑卒中患者160例,分为脑梗死组(80例)和脑出血组(80例),选择同期健康体检者45例作为对照组。用ELISA法检测神经元特异性烯醇化酶(NSE)、血管性血友病因子(v WF)、S100β蛋白(S100β)、基质金属蛋白酶-9(MMP-9)、单核细胞趋化蛋白-1(MCP-1)、血管细胞黏附分子-1(VCAM-1)水平,评估不同蛋白指标组合诊断脑梗死的敏感度和特异度。结果脑梗死组NSE、v WF、S100β、MMP-9、MCP-1和VCAM-1均高于对照组,差异有统计学意义(P<0.01);脑出血组除MCP-1外,各指标均高于对照组,差异有统计学意义(P<0.01)。由NSE、v WF、S100β、MCP-1和VCAM-1组成的诊断标志组,其诊断脑梗死的敏感度为73.75%、特异度为72.00%,发病6 h内诊断脑梗死的敏感度为80.77%,特异度为76.32%。结论蛋白指标联合诊断早期脑梗死的敏感度较高。

Objective To investigate the value of combined detection of six proteins in early diagnosis of cerebral infarction. Methods 160 patients with acute stroke within 72 hours were enrolled, including 80 patients with cerebral infarction and 80 patients with hemorrhagic stroke. At the same time, 45 healthy controls were enrolled. The concentrations of neuron-specific enolase （NSE） ,von Willebrand faetor（vWF）, protein S100β（S100β）, matrix metalloproteinase 9 （MMP-9）, monocyte chemotactic protein I（MCP-1） and vascular cell adhesion molecule 1（VCAM-1） in blood were determined by enzyme-linked immunosorbent assay（ELISA）. The sensitivity and specificity of different protein panels in diagnosing cerebral infarction were evaluated. Results Com- pared with control, the levels of NSE, vWF, S100β, MCP-1, MMP-9 and VCAM-1 were significantly higher in patients with cerebral infarction and hemorrhagic stroke,except the MCP-1 in patients with hemorragic stroke （P〈0.01）. The protein panel consisting of NSE, vWF,S100β, MCP-1 and VCAM-1 had a sensitivity of 73.75% and specificity of 72.00% for diagnosing cerebral infarction,and a sensitivity of 80.77% and specificity of 76.32% for diagnosing cerebral infarction within 6 hours from symptom onset. Conclusion A protein panel composed of NSE, vWF, S100i3, MCP-1 and VCAM-1 provided high sensitivity in diagnosing cerebral infarction within 6 hours from symptom onset.