同型半胱氨酸和β_2微球蛋白与脑梗死的关系

Homocysteine and β_2-microglobulin and cerebral infarction relations research

目的研究同型半胱氨酸(Hcy)、β2微球蛋白(β2MG)与脑梗死诊断和预后监测的临床价值。方法分析本院87例脑梗死患者及91例体检中心健康人员的血清Hcy、β2MG的水平及临床资料,对脑梗死各期与正常对照组比较及梗死灶大小、梗死神经功能缺损程度之间的水平含量比较,并应用受试者工作特性(ROC)曲线,对血清Hcy、β2MG水平含量进行分析,评价在脑梗死患者的临床诊断与监测价值。结果 87例脑梗死患者血清Hcy、β2MG水平含量显著高于91例健康体检人员,且差异有统计学意义(P<0.01);脑梗死急性期与恢复期比较,差异有统计学意义(P<0.05);恢复期与正常对照组比较,差异有统计学意义(P<0.05);脑梗死不同大小病灶之间比较,差异有统计学意义(P<0.05);脑梗死神经功能缺损程度之间比较,差异有统计学意义(P<0.05)。根据ROC曲线确定Hcy的临界值为10.9μg·L-1,诊断灵敏度为96.3%,特异度为84.1%,ROC曲线下面积(AUC)为0.931。确定β2MG的临界值为2.7mg·L-1,诊断灵敏度为91.5%,特异度为82.7%,ROC曲线下面积(AUC)为0.875。结论血清Hcy、β2MG均作为脑梗死的一项独立危险因素,在临床诊断中有较高的灵敏性和特异性。

Objective To study homocysteine （Hcy）, β2 microglobulin （ β2MG） the clinical value of senile cerebral infarction diagnosis and prognosis monitoring. Methods Retrospective analysis of hospital 87 cases of patients with cerebral infarction and 91 cases of examination center health staff serum Hcy levels and clinical data β2MG, senile cerebral infarction and normal control group and the infarct size, infarct nerve function the defect level between the level of content and application of receiver operating characteristic （ROC） curve, senile cerebral infarction serum the Hcy, β2MG level content analysis and evaluation of the value of the clinical diagnosis and monitoring. Results The 87 patients with cerebral infarction in patients with Hcy β2MG level content were significantly higher than the 91 cases of elderly healthy volunteers, and the difference was statistically significant （P〈0.01） ; elderly patients with acute cerebral infarction and convalescent difference was statistically significant P〈0.05; convalescence and normal control group, the difference was statistically significant （P〈 0.05 ）; senile cerebral infarction comparison between the different size of lesions, the difference was statistically significant （P〈0.05） ; senile cerebral infarction nerve function defect between the degree of comparison, the difference was statistically significant, P〈 0.05; under the ROC curve the Hcy＇s critical value 10.91μg · L^-1, the diagnostic sensitivity 96.3% ,Specificity for 84.1%. ROC area under the curve （AUC） for0.931 ; Determine β2MG the critical value of 2.7mg · L^-1, the diagnostic sensitivity91.5% , Specificity for 82.7%, The area under the ROC curve （AUC） for the 0.875. Conclusion Serum Hcy and β2MG are as an independent risk factor for cerebral infarction with high sensitivity and specificity in clinical diagnosis.