Hcy、ACA、FA联合检测在预测脑梗死发生中的临床价值

Clinical values of combined detection of homocystine, folate & anti-cardiolipin antibodies in prediction of cerebral infarction

目的:探讨Hcy、ACA、FA联合检测在预测脑梗死发生中的临床价值。方法:采用EILSA及化学发光免疫分析技术,对66例脑梗死患者和30例健康对照者进行血清的ACA、Hcy及FA的检测。结果:脑梗死患者Hcy浓度为[(22.68±12.70)μmol/L]明显高于健康对照组[(13.38±2.61)μmol/L],差异非常显著(P<0.01)。叶酸[(3.87±2.02)pg/ml]水平明显低于健康对照组[(519.37±437.57)ng/mL](P<0.05);脑梗死患者ACA和高Hcy血症的检出率为53.03%和68.18%与健康对照组(16.67%)比较,差异非常显著(P<0.01);ACA、Hcy及FA单独预测脑梗死的敏感性分别为87.50%、90.00%和96.3%;特异性为44.60%、54.40%和37.09%;在预测脑梗死发生中ACA、Hcy及FA联合检测优于单项检测。结论:高Hcy血症和ACA均是脑梗死发病的独立的危险因素。ACA可能参与脑血管病变的发病过程。ACA、Hcy及FA联合检测可较好地预测脑梗死的发生,其中以ACA和Hcy联合检测为最佳,对于预测脑梗死发生具有较高的临床价值。

Objective： To exploret The clinical values of Combined Detection of homocystine, folate and Anti-cardiolipin antibodies for the prognostication of cerebral infarction. Methods： The serum levels of ACA ,Hcy and folate in 66 cases of cerebral infarction and 30 healthy people as controls were measured by ELISA and chemilum inescence immunoassay （CLIA）. Results： The serum Hcy levels in patients of cerebral infarction were [（22.68±12.70）μmol/L]compared with sig nificantly higher than those in healthy controls [（13.38±2.61）μmol/L], between has significantly difference（p〈0.01）;whereas the folate levels[（3.87±2.02）pg/ml]were significantly lower between has markable difference （p〈0.05）than those in healthy controls. The positive rate of Anti-cardiolipin antibodies （ACA）and hyper-homocy steinemia（Hhcy）in cerebral infarction patient swere 68.18% in cere-bral infarction patients were 53.03% there was significant difference compared with the healthy controls（16.67%）（p〈0.01）. The sensitivity for each single of Hcy, ACA and FA in the diagnosis of cerebral infarction was 87.50% , 90.00% and 96.3% respectively, specificity was 44.60% , 54.40% and 37.09% respectively. The combined detection of Hcy, ACA and FA were superior to individual testing. Conclu sions： The high serum level of homocysteine and ACA positive is an independent risk factor for cerebral infarction. The Hhcy and Anti-cardiolipin antibodies（ACA）seem to behave as risk factors for cerebral infarction patients which may contribute to the process of patients with cerebral infarction. The combined use of Hcy, ACA and FA can help prognostication of cerebral infarction and the combined use of Hcy and ACA is the best, which have high clinical values. It is could make for prognostication of cerebral infarction.