同型半胱氨酸和超敏C反应蛋白联合检测对急性脑梗死的诊断价值分析

Clinical value of detection of homocysteine and high sensitive C reactive protein in diagnosis of patients with acute cerebral infarction

目的探讨同型半胱氨酸（Hcy）和超敏C反应蛋白（hs·CRP）检测对急性脑梗死（ACI）诊断的应用价值。方法选择15例ACI患者纳入研究组，依据汉密尔顿抑郁量表（HAMD）将其分为抑郁组（5例）和非抑郁组（10例），另选择同期健康体检者15例纳入对照组，取受检者清晨空腹静脉血，采用酶联免疫吸附法和散射化浊法检测Hey、hs．CRP水平，并进行对比分析。结果研究组血清Hcy（16．70±2．65）μmol／L、hs-CRP（10．16±1．08）mg／L，较对照组均明显增加，差异有统计学意义（t=8．55、9．31，均P〈0．05）；中度组患者血清Hcy（16．28±2．09）ixm01．／L、hs．CRP（10．23±1．32）mg／L，较轻度组均明显增加，差异均有统计学意义（t=6．75、8．56，均P〈0．05）；重度组血清Hcy（20．54±2．54）μmol／L、hs-CRP（15．10±1．49）mg／L，较轻度组和中度组均明显增加，差异均有统计学意义（t=6．64、7．88、6．69、6．44，均P〈0．05）。中梗死组血清Hcy（15．78±1．56）μmol/L、hs．CRP（10．54±1．67）mg／L，较小梗死组均明显增加，差异均有统计学意义（￡=6．36、7．83，均P〈0．05）；大梗死组血清Hey（21．77±2．05）μmol／L、hs-CRP（16．76±1．79）mg／L，较小梗死组和中梗死组比较均明显增加，差异均有统计学意义（t=6．70、7．55、6．46、6．65，均P〈0．05）。抑郁组脑梗死患者血清Hcy（19．98±2．69）μmol／L、hs-CRP（14．06±1．93）ms／L，较非抑郁组均明显增加，差异均有统计学意义（t=6．87、7．50，均P〈0．05）。结论同型半胱氨酸和超敏C反应蛋白检测在急性脑梗死患者诊断中有极高应用价值，值得推广。

Objective To explore the application value of combined detection of homocysteine （Hcy） and high sensitive C reactive protein （hs- CRP） in diagnosis of patients with acute cerebral infarction （ACI）. Methods 15 cases with ACI were selected as the study group. According to Hamilton Depression Scale （HAMD） ,the patients were divided into depression group （n = 5 ） and non - depression group （ n = 10）, another 15 healthy persons were selected as control group. The fasting venous blood was extracted in the early morning,the levels of Hcy and hs - CRP were detected by enzyme linked immunosorbent assay and turbidimetry, and the results were analyzed. Results The serum levels of Hcy and hs- CRP in the study group were （16.70± 2.65 ）μmol/L, （10.16± 1.08 ）mg/L,respec- tively, which were significantly higher than those in the control group, the differences were statistically significant （t = 8.55,9. 31 ,all P 〈0.05）. The serum levels of Hcy and hs - CRP in the moderate group were （ 16.28 ±2.09） μmol/L, （10.23± 1.32）mg/L,respectively ,which were significantly higher than those in the mild group ,the differences were statistically significant （ t = 6.75,8.56, all P 〈 0.05 ）. The serum levels of Hcy and hs - CRP in the severe group were （20.54 ± 2.54） μmol/L, （ 15.10 ± 1.49 ） mg/L, respectively, which were significantly higher than those in the mild group and moderate group, the differences were statistically significant （ t = 6.64,7.88, t = 6. 69,6.44, all P 〈 0. 05 ）. The serum Hcy,hs - CRP levels in patients with middle cerebral infarction group were （ 15.78 ± 1.56） μmol/L, （10.54 ± 1.67）mg/L, respectively, which were significantly higher than those in the small infarction group, the differences were statistically significant （ t = 6.36,7.83, all P 〈 0.05 ）. The serum Hcy, hs - CRP levels in the patients with large infarction group were （ 21.77 ± 2.05 ） μmol/L, （ 16.76 ±1.79 ） mg/L, respectively, which were significantly increased compared with the small infarction group and the middle infarction group, the differences werestatistically significant （ t = 6.70,7.55, t = 6.46,6.65, all P 〈 0. 05 ）. The serum levels of Hcy and hs - CRP in ACI patients with depression were （ 19.98 ± 2. 69） μmol/L and （ 14. 06 ± 1. 93 ） mg/L, respectively, which were significantly higher than those in the non - depression group （ t = 6.87,7.50, all P 〈 0.05 ）. Conclusion Detection of Hcy and hs - CRP has high application value in the early prevention and diagnosis of patients with ACI, it is worthy of promoting.