脑梗死患者同型半胱氨酸与血脂相关性及其诊断价值

Correlation study between Hcy and blood lipid level and its diagnostic value in patients with cerebral infarction

目的研究同型半胱氨酸(Hcy)与血脂的相关性及Hcy在脑梗死中的诊断价值。方法将我院神经内科住院患者218例,根据头颅CT或MRI检查,分为脑梗组109例,非脑梗组109例,并以健康体检者60例作对照组,各组均行Hcy和血脂TC、TG、HDL-c、LDL-c检测。以Hcy作诊断试验指标,头颅CT和MRI检查作为诊断的金标准,测量其敏感性、特异性、预测值和似然比。结果两组TC和Hcy均高于对照组(P<0.01),脑梗组HDL-c低于对照组(P<0.05),且Hcy与HDL-c呈负相关(r=-0.144,P<0.05),表明高Hcy血症与HDL的降低有关。Hcy试验敏感性为42.20%、特异性为54.13%、阳性预测值和阴性预测值分别为47.92%和48.36%、阳性似然比和阴性似然比比值分别为0.97和1.07。结论 Hcy与血脂有一定的相关性,但Hcy对脑梗死的诊断价值较低,不能作为脑梗死诊断的生物学标记物。

Objective To investigate the correlation between Hcy and blood lipid level and its diagnostic value in patients with cerebral infarction. Methods 218 patients with cerebral infarction were divided into the cerebral infarction group and no cerebral infarction group, based on the diagnosis results of head CT or MRI, and 60 healthy individuals were used as the control group. The levels of serum TC, TG, HDL-c, LDL-c and serum Hcy were determined in each group. The level of serum Hcy was used as a diagnostic-test and the criterion of cerebral infarction which was diagnosed by using head CT or MRI was used as a gold standard. Meanwhile, the sensibility, specificity, predictive value and likelihood ratio of Hcy were measured in patients with and without cerebral infarc- tion. Results Levels of TC and Hcywere significantly elevated （P 〈 0.01 ） , but HDL-c level was significantly decreased in patients with and without cerebral infarction compared with the healthy people （P 〈 0.05）. Hcy level was shown negatively correlated with HDL-c （r = -0.144, P 〈 0.05）. The sensibility and specificity of Hcy in both two groups of patients with and without cerebral infarction were 42.20% and 54.13%, the positive predictive value and negative predictive value of Hcy were 47.92% and 48.36%, the positive likelihood ratio and negative likelihood ratio of Hcy were 0.92 and 1.07, respectively. Conclusion Hcy and blood lipid have definite correlation, but Hcy has low diagnostic value for cerebral infarction and may not be used as a biological marker for the cerebral infarction diagnosis.