血浆中特定磷脂与慢性脑供血不足的相关研究

Correlation of specific plasma phospholipids with chronic cerebral circulation insufficiency

目的探讨慢性脑供血不足(CCCI)与血浆中特定的磷脂(AP)的相关性,以评价AP是否可以作为诊断CCCI的标准之一。方法选择CCCI患者1212例为CCCI组,同期选择无CCCI症状者202例为对照组,用比色法测定AP。采用ROC曲线下面积等评估测定AP的准确性。结果与对照组比较,CCCI组血浆AP水平显著升高[(6.27±0.69)Uυs(4.37±0.79)U,P<0.01]。CCCI组血浆AP水平与年龄无相关性(r=0.001,P=0.902)。用血浆AP作为CCCI的诊断方法的准确性较高,其ROC曲线下面积为0.961(95%CI:0.946～0.976,P<0.01)。AP正常界值=5.39 U时,敏感性为92.1%,特异性为89.1%。结论 CCCI患者具有血浆AP水平升高的生化特性。AP可能是诊断CCCI的一个较好的分子标记物。

Objective This study was aimed at elucidating the relationship of chronic cerebral circu- lation insufficiency（CCCI） with the plasma levels of a sort of phospholipid（AP） with the solubili- ty similar to lysophosphatidic aeid（LPA）,so as to evaluate the accuracy of AP as a diagnostic index. Methods 1212 cases were consecutively enrolled in this case-control study. 202 controls were selected in the similar manner. Fasting blood was extracted from both cases and controls to assay phospholipids by colorimetry. Receiver operating characteristic curve （ROC） etc. were used to evaluate the accuracy of test. Results Plasma AP levels of patients with CCCI were significantly higher than controls[（6.27±0.69） U vs （4.37±0.79） U,P〈0. 01]. Plasma AP was not correlated with age（r=0. 001 ,P=O. 902）. The accuracy of AP test of CCCI is rather high. The area un- der ROC was 0. 961（95%CI：0. 946-0. 976 ,P〈0.01）. At the cut-off value 5.39 U,the sensitivity was 92.1% and specificity was 89.1%. Conclusion The so-called CCCI has unique biochemical characteristics of elevated plasma levels of AP, which should be further explored even including its nomenclature. This study strongly suggested that AP is a good diagnostic marker.