血清Hcy、hs-CRP在急性脑梗死患者的表达及与病情程度的相关性

Correlation between the expression of serum Hcy and hs⁃CRP in patients with acute cerebral infarction and its severity

目的探究急性脑梗死(ACI)患者血清同型半胱氨酸(Hcy)、超敏反应蛋白(hs-CRP)表达水平与病情严重程度的相关性。方法选取110例ACI患者,分为轻度组(n=39)、中度组(n=46)和重度组(n=25),另选取50例健康志愿者作为对照组,对比各组研究对象临床基本资料、血生化指标,并比较各组ACI患者梗死病灶面积、颈动脉狭窄程度及预后mRS评分;观察不同梗死病灶面积、不同颈动脉狭窄程度、神经功能缺损程度评分(NDS)及预后评分(mRS)患者血清Hcy、hs-CRP水平,受试者工作特征曲线(ROC)分析Hcy、hs-CRP对于ACI的诊断价值。结果各组性别构成、年龄、吸烟史、身体质量指数(BMI)比较,差异无统计学意义(P>0.05);各组血糖、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)、活化部分凝血酶时间(APTT)、Hcy、hs-CRP比较,差异有统计学意义(P<0.05)。随着ACI患者梗死病灶面积、颈动脉狭窄、NDS及mRS评分增加血清Hcy、hs-CRP水平明显升高,差异具有统计学意义(P<0.05)。Hcy、hs-CRP与TC、TG、LDL-C、PT、TT、FIB、APTT、梗死病灶面积、颈动脉狭窄、NHISS评分、NDS评分及mRS评分存在显著正相关性(P<0.05)。血清Hcy、hs-CRP及二者联合诊断ACI的曲线下面积(AUC)分别为0.801、0.899、0.928,联合诊断更具显著价值。结论急性脑梗死患者血清Hcy、hs-CRP与机体高血脂、高凝血状态、神经功能缺损存在密切关系,Hcy、hs-CRP对于急性脑梗死患者病情严重程度辅助评估具有显著价值。

Objective To investigate the correlation between the expression levels of serum homocysteine(Hcy)and hypersensitivity protein(hs⁃CRP)in patients with acute cerebral infarction(ACI)and the severity of the disease.Methods 110 patients with ACI were selected and divided into the mild group(n=39),the moderate group(n=46)and the severe group(n=25),another 50 healthy volunteers were selected as the control group.The basic clinical data and blood biochemical indexes of each group were compared,and the area of infarct lesions,carotid artery stenosis and prognostic mRS scores of ACI patients in each group were compared.The serum Hcy and hs⁃CRP levels of patients with different infarct area,different carotid artery stenosis degree,neurological deficit score(NDS)and different prognosis mRS score were compared,and the receiver operating characteristic curve(ROC)analyzed Hcy and hs⁃CRP for the diagnostic value of ACI.Results There was no statistically significant difference in gender composition,age,smoking history,and body mass index(BMI)among the groups(P>0.05).Blood glucose,total cholesterol(TC),triglycerides(TG),high⁃density lipoprotein cholesterol(HDL⁃C),low⁃density lipoprotein cholesterol(LDL⁃C),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB),activated partial thrombin time(APTT),Hcy,hs⁃CRP in each group were compared,the difference was statistically significant(P<0.05).With the increase of infarct size,carotid artery stenosis,NDS and mRS scores in ACI patients,the serum Hcy and hs⁃CRP levels increased significantly,the difference was statistically significant(P<0.05).There was a significant positive correlation between Hcy,hs⁃CRP and TC,TG,LDL⁃C,PT,TT,FIB,APTT,infarct size,carotid stenosis,NHISS score,NDS score,and mRS score(P<0.05).The areas under the curve(AUC)of serum Hcy,hs⁃CRP and the combined diagnosis of ACI were 0.801,0.899,0.928,respectively,and combined diagnosis is more significant.Conclusion Serum Hcy and hs⁃CRP in patients with acute cerebral infarction are closely related to the body􀆳s hyperlipidemia,hypercoagulability,and neurological deficits.Hcy and hs⁃CRP are of great value in the auxiliary evaluation of the severity of acute cerebral infarction.