CD62p在诊断急性脑梗死疾病中的作用

Role of CD62p in the diagnosis of acute brain infarction disease

目的通过测定血小板膜糖蛋白CD62p的表达率,探讨其与急性脑梗死的关系,绘制ROC曲线,确定阴阳性截点,阐明临床意义。方法使用流式细胞仪采用FITC和PE双标定法检测急性脑梗死组患者血浆CD62p阳性率,并与高危组及正常人组进行对照研究,对CD62p与脑梗死的关系进行ROC曲线分析,确定CD62p阳性率适用于判断急性脑梗死的最佳截点。结果病例组CD62p阳性表达率显著高于高危组及对照组(P<0.01)。动态观察病例组CD62p阳性表达率,第24 h血浆CD62p表达率最高,第7 d、第14 d呈逐渐下降趋势,但第14 d时仍高于高危组及对照组(P<0.01)。使用CD62p阳性表达率绘制ROC曲线,最终选取CD62p阳性表达率5.20%为截点,得出结果提示敏感度92%,特异度95%,阳性预测值98%,阴性预测值73%,符合率(正确率)92%。结论在急性脑梗死组、高危组患者体内血小板发生活化的程度增加,但急性脑梗死组血小板活化程度更高,并且CD62p的阳性表达率越高提示病情越重。经CD62p阳性表达率绘制的ROC曲线证实,当检测CD62p高于5.2%时,预示发生脑梗死的可能性极大,为进一步寻找脑梗死早期筛查指标奠定了基础。

Objective To explore the relationship between the expression rate of platelet membrane glycoprotein CD62 p and acute cerebral infarction,draw ROC curve,determine the cutoff value,and clarify its clinical significance. Methods Flow cytometry that adopts FITC and PE double calibration was used to detect CD62 p positive rates in the plasma of acute cerebral infarction group patients,then comparative analyses were performed between the high-risk group and the control group. The relationship between the CD62 p and cerebral infarction was analyzed by drawing the ROC curve and it was confirmed that the CD62 p positive rate was applicable to determine the best cutoff value of acute cerebral infarction. Results Acute cerebral infarction group had a significantly higher positive CD62 p expression rate than the high risk group and the control group,which are all statistically significant（ P〈0. 01）. Dynamic observation of the CD62 p positive expression rate of acute cerebral infarction group showed that plasma CD62 p expression rate was the highest in 24 h,a trend of gradual decline on 7 d and 14 d,but remained higher than that of the high risk group and the control group on 14 d. The results are statistically significant（ P〈0. 01）. ROC curve drown by using CD62 p positive expression rate showed that 5. 20% was the cutoff point. The sensitivity was 92%,specificity 95%,positive predictive value 98%,negative predictive value of 73% and coincidence rate（ accuracy） 92%. Conclusion In the patients of both the acute cerebral infraction group and high risk group,the platelet was kept high level,but the platelet activation in acute cerebral infarction group was higher,and in turn it can be speculated that the higher the positive expression rate of CD62 p,the serious the patient＇s condition. When the detected CD62 p is higher than 5. 2% after analyzing the ROC curve which is drawn based on CD62 p positive expression,it indicates very high possibility of cerebral infraction. Therefore,measuring CD62 p could predict the occurrence of acute cerebral infarction.