联合检测HCY、D-二聚体和Hs-CRP在急性脑梗死中的临床意义

Clinical significance of combined detection of HCY,D-dimer and Hs-CRP in acute cerebral infarction

目的探讨联合检测HCY、D-二聚体和Hs-CRP在急性脑梗死中的临床意义。方法纳入114例经临床及影像学确诊的ACI患者(ACI组)和80例健康体检者(对照组),比较不同NDS评分ACI患者与对照组HCY、D-二聚体、Hs-CRP水平的差异,分析ACI恢复期3项指标水平的变化,比较3项指标不同组合联合检测对诊断ACI的价值。结果 ACI轻、中、重3组患者HCY、D-二聚体、Hs-CRP水平均明显高于对照组,差异有统计学意义(P<0.05),且其水平随着病情进展逐渐升高,轻、中、重三组间差异有统计学意义(P<0.05或P<0.01);恢复期3项指标水平均有不同程度下降,Hs-CRP下降趋于正常,但HCY、D-二聚体仍高于对照组(P<0.05);HCY+D-二聚体+Hs-CRP联合检测对诊断ACI的敏感性最高、特异性最强、约登指数最大。结论 HCY、D-二聚体、Hs-CRP水平的变化与ACI的发生、发展密切相关,三者联合检测有助于临床诊断ACI,并判断病情严重程度。

Objective To explore the clinical significance of combined detection of HCY,D-dimer and hs- CRP in acute cerebral infarction. Methods 114 patients （ACI group） and 80 health checkers （control group） who were diagnosed with clinical and radiological diagnosis were collected,and the HCY,D-dimer and Hs-CRP level of ACI patients with different NDS scores were compared,the change of the three indexes of ACI recovery period were analyzed,The value of ACI was diagnosed by comparison of three different combinations. Results The level of HCY,D-dimer and hs-CRP in three groups which the ACI patients＇ state were mild,moderate and severe were significantly higher than those in control groups（P 〈 0.05）,and as the disease progresses,the progress gradually increases,the differences between the three groups which the ACI patients＇ state were mild, moderate and severe were statistically significant （P 〈 0.05 or P 〈 0.01）.In the recovery period,the level of the three indexes decreased,and the hs- crp decreased to normal,however,the HCY,D-dimer were still higher than those of control group （P 〈 O.05）.The combined detection of HCY,D-dimer and hs-CRP had highest sensitivity,highest specificity and largest yiden index in the diagnosis of ACI. Conclusion The change of HCY,D-dimer and hs-CRP is closely related to the development of ACI,combined detection of three indexes can contribute to the clinical diagnosis of ACI and determine the severity of the disease.