血清CTRP3、CTRP9在急性脑梗死患者中的表达及诊断价值研究

Clinical value of serum CTRP3 and CTRP9 in diagnosis of acute ischemic stroke

目的研究血清CTRP3、CTRP9在急性脑梗死(ACI)患者中的表达及对ACI的诊断价值。方法选取2017年6月-2018年6月在延安大学附属医院就诊的85例ACI患者作为观察组,另选该院同期健康体检者80例作为对照组。比较两组血清CTRP3、CTRP9水平并分析其诊断价值,Logistic回归模型拟合联合诊断,通过受试者工作特征曲线,分析两者联合诊断潜力。结果观察组血清CTRP3、CTRP9水平低于对照组(P<0.05)。以CTRP3≤295.22 ng/ml为截断值,其对ACI诊断的敏感性为76.47%(95%CI:0.658,0.847),特异性为78.75%(95%CI:0.679,0.868),AUC为0.803(95%CI:0.751,0.854)。以CTRP9≤282.15 ng/ml为截断值,其对ACI诊断的敏感性为74.12%(95%CI:0.633,0.827),特异性为88.75%(95%CI:0.792,0.944),AUC为0.763(95%CI:0.710,0.816)。联合诊断模型诊断ACI的敏感性为81.18%(95%CI:0.709,0.885),特异性为76.25%(95%CI:0.652,0.847),AUC为0.870(95%CI:0.832,0.908);同时联合诊断模型AUC高于CTPR3和CTPR9。结论血清CTRP3、CTRP9水平与ACI发病密切相关,可用于ACI的辅助诊断,且联合检测能提高其诊断的敏感性,为ACI的早期诊断提供可靠证据。

Objective To study the clinical value of serum CTRP3 and CTRP9 in acute ischemic stroke(AIS).Methods We selected 85 patients with AIS(diagnosed within 24 h)as subjects of observation group,and meanwhile,80 healthy subjects as control group.Serum CTRP3 and CTRP9 were measured and compared between these 2 groups.Logistic regression model was implemented to fit the joint diagnosis.And the diagnostic value of each index was analyzed by the working characteristic curve of the subjects.Results The serum CTRP3 and CTRP9 in control group were higher than those in observation group(P<0.05).At the cut-off value as 295.22 ng/ml,the sensitivity,specificity and 95%AUC of CTRP3 were 76.47%(95%CI:0.658,0.847),78.75%(95%CI:0.679,0.868),0.803(95%CI:0.751,0.854),respectively.While the cut-off value of CTRP9 is 282.15ng/ml,the sensitivity,specificity and 95%AUC were 74.12%(95%CI:0.633,0.827),88.75%(95%CI:0.792,0.944),0.763(0.710,0.816),respectively.The sensitivity,specificity and 95%AUC of joint diagnostic model were 81.18%(95%CI:0.709,0.885),76.25%(95%CI:0.652,0.847),0.870(0.832,0.908),respectively,which were evidently higher than them of CTRP3 and CTRP9.Meanwhile,the AUC of joint diagnosis(0.870)were also higher than them of CTRP3(0.803)and CTRP9(0.763).Conclusion Serum CTRP3 and CTRP9 are evidently related to AIS and their joint diagnosis could provide helpful support for the timely diagnosis of AIS.