血清SAA、IMA及NSE联合检测对急性缺血性脑卒中的诊断价值

Diagnostic value of serum SAA,IMA and NSE in acute ischemic stroke

目的探讨血清淀粉样蛋白A(serum amyloid A,SAA)、缺血修饰白蛋白(ischemia modified albumin,IMA)及神经元特异性烯醇化酶(neuron-specific enolase,NSE)联合检测对急性缺血性脑卒中(AIS)的诊断价值。方法选取2015年1月~2018年12月南京医科大学附属江宁医院收治的102例AIS患者为AIS组,80例健康体检者为对照组。检测两组血清SAA、IMA及NSE水平,分析血清SAA、IMA及NSE水平与梗死体积、NIHSS评分的相关性,采用受试者工作特征曲线(ROC)探讨3项指标对AIS的诊断效能。结果AIS组患者血清SAA、IMA及NSE水平均显著高于对照组,差异有统计学意义(P<0.05)。Logistic回归显示,高血压以及血清SAA、IMA、NSE水平升高与AIS的发生存在密切联系(P<0.05),AIS患者血清SAA、IMA、NSE水平与脑梗死面积、NIHSS评分均呈显著正相关(P<0.05)。单独检测SAA、IMA、NSE诊断AIS的AUC为0.872、0.852、0.837,3项指标联合检测的AUC为0.949,灵敏度为88.2%,特异度为88.7%。结论血清SAA、IMA、NSE与AIS患者脑损伤程度和梗死体积正相关,联合检测血清SAA、IMA、NSE水平有利于AIS的早期诊断。

Objective To investigate the diagnostic value of serum amyloid A(SAA),ischemia modified albumin(IMA)and neuron-specific enolase(NSE)in acute ischemic stroke(AIS).Methods 102 AIS patients were selected as AIS group and 80 healthy subjects as control group.Serum SAA,IMA and NSE levels in two groups were detected.The correlation between serum SAA,IMA and NSE levels and infarct volume,NIHSS score was analyzed.The diagnostic efficacy of three indexes for AIS was investigated by using ROC.Results SAA,IMA and NSE levels in AIS group were significantly higher than control group(P<0.05).Logistic regression showed that hypertension and increased of serum SAA,IMA and NSE levels were closely related to the occurrence of AIS(P<0.05).Serum SAA,IMA and NSE levels of AIS patients were significantly positively correlated with cerebral infarction area and NIHSS score(P<0.05).The AUC of SAA,IMA and NSE for AIS diagnosis alone was 0.872,0.852 and 0.837.The AUC of combined detection was 0.949,with the sensitivity was 88.2%and the specificity was 88.7%.Conclusion Serum SAA,IMA and NSE are positively correlated with brain injury degree and infarct volume in AIS patients.Combined detection of serum SAA,IMA and NSE levels is beneficial to the early diagnosis of AIS.