泛素C末端水解酶-1在急性缺血性脑血管病早期鉴别中的价值

Value of ubiquitin C-terminal hydrolase-L1 in early differentiation of acute ischemic cerebrovascular disease

目的评价血清泛素C末端水解酶-1(UCH-L1)在急性缺血性脑血管病早期鉴别中的价值。方法发病6 h内表现为急性局灶性神经功能缺损的102例患者分为超急性脑梗死(HCI)组(除外腔隙性脑梗死)、腔隙性脑梗死(LCI)组和短暂性脑缺血发作(TIA)组。用夹心ELISA测定患者血清(发病6 h内)UCH-L1。结果 HCI组血清UCH-L1水平显著高于LCI组(P<0.01)和TIA组(P<0.01)。LCI组血清UCH-L1水平与TIA组差异无统计学意义(P>0.05)。血清UCH-L1诊断HCI的ROC曲线下面积为(0.793±0.047)(P<0.01)。当血清UCH-L1≥0.17μg/L时,诊断HCI的灵敏度为72.5%,特异度为74.2%。结论血清UCH-L1水平有助于超急性脑梗死与短暂性脑缺血发作和腔隙性脑梗死的鉴别。

Objective To evaluate the value ofubiquitin C-terminal hydrolase-L1 （UCH-L1） in early differ- entiation of acute ischemic cerebrovaseular disease. Methods Patients with sudden appearance of focal neurological deficit within 6 hour from onset were divided into hyperacute cerebral infarct （HCI） group （except for lacuna cerebral infarct）, lacuna cerebral infarct （LCI） group, transient ischemic attack （TIA） group. UCH-L1 in serum within 6 hour from onset was determined by ELISA. Results Level of serum UCH-L1 was significantly higher in HCI group than that in LCI group （P〈0.001） and in TIA group （P〈0.001）. Level of serum UCH-L1 in LCI group had no difference with that in TIA group （P〉0.05）. Area under ROC curve for serum UCH-L1 to diagnose HCI was （0.793±0.047） （P〈0.001）. When serum UCH-L1 was over or equal to 0.17 μg/L, HCI was determined with 72.5% sensitivity, 74.2% specificity. Conclusions Levels of serum UCH-LI help to differentiate HCI （except for LCI） from TIA and LCI.