血清总唾液酸、超敏C反应蛋白和总同型半胱氨酸联合检测对急性脑梗死的诊断价值

Clinical Value of Combined Detection of Serum Total Sialic Acid,High Sensitivity C-reactive Protein and Homocysteine in Patients with Acute Cerebral Infarction

目的:分析血清总唾液酸(TSA)、超敏C反应蛋白(hs-CRP)和总同型半胱氨酸(tHCY)联合检测对急性脑梗死(ACI)的诊断价值。方法:采用病例对照检测分析233例ACI住院患者(ACI组)和100例健康者(对照组)血清TSA、hs-CRP及tHCY水平差异及各指标的相关性;ROC曲线分析各指标单检和联检对ACI的诊断价值。结果:ACI组血清TSA、hs-CRP和tHCY水平均较对照组显著升高(P均<0.01),且血清TSA与hs-CRP同步升高,二者水平呈显著正相关(r=0.553,P<0.01),而TSA与tHCY水平、hs-CRP与tHCY水平无明显相关性(r=0.037、-0.032,P>0.05);血清TSA、hs-CRP和tHCY单检诊断ACI的ROC曲线下面积(AUC)分别为0.770、0.870、0.877,三指标联合检测诊断ACI的AUC为0.957,均大于各指标单检(P<0.01);三指标联检敏感度(90.1%)与tHCY单检无差异(P>0.05),但明显高于TSA单检(55.8%)和hs-CRP单检(70.8%)(P均<0.05);三指标联检特异度(84.4%)与tHCY单检(80.3%)相近(P>0.05),但明显低于TSA单检(99.8%)和hs-CRP单检(93.9%)(P<0.05)。结论:ACI患者血清TSA、hs-CRP及tHCY水平升高;三指标联合检测可能提高ACI临床诊断效能。

Objective：To evaluate the clinical value of combined detection of serum total sialic acid（TSA）,hsCRP and total homocysteine（tHCY）in the diagnosis of acute cerebral infarction（ACI）.Method：One hundred healthy subjects（control group）and 233 ACI patients（case group）were included.The levels of serum TSA,hsCRP and tHCY were detected and then do statistical analysis of indicators from the two groups,and the correlation between the indicators.Results：Compared with the control group,the levels of TSA,hs-CRP,and tHCY in case group were significantly increased（P were all〈0.01）,also,serum TSA and hs-CRP levels were significantly positively correlated（r=0.553,P〈0.01）in ACI patients,but TSA was not significantly correlated with tHcy and hsCRP（r=0.037and-0.032,P〉0.05）.The area under ROC curve of TSA,hs-CRP and tHCY in the diagnosis of ACI were 0.770,0.870 and 0.877 respectively,P were all〈0.01.Area under the ROC curve of combined detection of serum TSA,hs-CRP and tHCY in the diagnosis of ACI was 0.957（P〈0.01）.Also,the sensitivity（90.1%）with the same tHCY single detection was significantly higher than that of TSA single detection（55.8%）and hs-CRP（70.8%）（P〈0.05）.The combined specificity（84.4%）is also similar with the tHCY（80.3%）,but was significantly lower than that of TSA single detection（99.8%）and hs-CRP（93.9%）（P〈0.05）.Conclusion：Combineddetection of serum TSA,hs-CRP and tHCY may improve the diagnostic efficacy of ACI.