血清Lp-PLA2,IMA和LDL-C水平检测与TCD联合检查在缺血性脑血管病早期诊断中的价值

Value of Detection of Serum Lp-PLA2,IMA and LDL-C Level and Combined TCD in Early Diagnosis of Ischemic Cerebrovascular Disease

目的研究脂蛋白相关磷脂酶A2(Lp-PLA2)、缺血修饰蛋白(IMA)、低密度脂蛋白胆固醇(LDL-C)及经颅多普勒超声(TCD)联合检测对缺血性脑血管病早期诊断的价值。方法采用研究-对照的研究方法,选取2018年11月~2019年3月某院收治的98例经影像学确诊为缺血性脑血管病患者作为研究组,选取同期进行常规体检的100例健康人员作为对照组,两组均进行血清中Lp-PLA2,IMA,LDL-C及TCD检测,对比分析检测结果。结果研究组Lp-PLA2,IMA,LDL-C及TCD检测水平均高于对照组,Lp-PLA2,IMA及TCD与对照组相比,差异具有统计学意义(t=12.984,12.820,25.645,均P<0.05);而LDL-C与对照组相比,差异无统计学意义(t=1.720,P>0.05)。对各组检测指标做ROC曲线分析:单项IMA和Lp-PLA2曲线AUC均达到0.9以上其试验准确性很高,TCD 0.7~0.9之间其试验的准确性高,LDL-C等于0.5其试验无诊断价值^([10])。联合结果为IMA+LDL-C+Lp-PLA2+TCD(0.963),IMA+Lp-PLA2+TCD(0.964)三项指标联合检测诊断时其诊断价值达到最大,它们之间相比其诊断价值差异均无统计学意义(P<0.05)。结论缺血性脑血管病患者血清中Lp-PLA2,IMA及TCD的水平显著升高,早期对高危人群进行血清Lp-PLA2,IMA,LDL-C及TCD检测可以预测缺血性脑血管病的发生,对早期诊断和干预缺血性脑血管病有较高的应用价值。

Objective To study the value of detection of serum lipoprotein-associated phospholipase A2(Lp-PLA2),ischemia-modifying protein(IMA) and low-density lipoprotein cholesterol(LDL-C) levels and combined TCD in early diagnosis of ischemic cerebrovascular diseases.Methods A study-control study was conducted to select 99 patients with ischemic cerebrovascular disease who were diagnosed by imaging in a hospital from November 20 to March 2019.100 healthy patients who underwent routine physical examination at the same time were selected.As a control group,the two groups were tested for serum Lp-PLA2,IMA,LDL-C and TCD,and the results were compared and analyzed.Results The levels of Lp-PLA2,IMA,LDL-C and TCD in the study group were higher than those in the control group.The difference between Lp-PLA2,IMA and TCD was statistically significant(t=12.984,12.820,25.645,all P<0.05).Comparing LDL-C with the control group,the difference was not statistically significant(t=1.720,P>0.05).The ROC curve analysis was carried out for each group of test indicators:the AUC of each single IMA and Lp-PLA2 curve reached 0.9 or higher,and the test accuracy was very high.The accuracy of the test was high between TCD 0.7~0.9,and the LDL-C was equal to 0.5[10].The combined results were the highest diagnostic value of IMA+LDL-C+Lp-PLA2+TCD(0.963) and IMA+Lp-PLA2+TCD(0.964).The diagnostic value was the highest,and no statistical significance(P<0.05).Conclusion The levels of serum Lp-PLA2,IMA and TCD are significantly elevated in patients with ischemic cerebrovascular disease.Early detection of serum Lp-PLA2,IMA,LDL-C and TCD in high-risk populations can predict ischemic cerebrovascular disease.Occurrence,has a high application value for early diagnosis and intervention of ischemic cerebrovascular disease.