脑梗死患者血清Hcy、hs-CRP及NEFA水平与患者预后的相关性分析

A Correlation Analysis Between Serum Hcy,hs-CRP and NEFA Levels and Prognosisin Patients with Cerebral Infarction

目的探讨脑梗死患者血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)及游离脂肪酸(NEFA)水平与患者预后的相关性。方法收集2018年6月至2019年6月医院收治的108例脑梗死患者(研究组)和同期体检70名健康志愿者(对照组)为研究对象。依据脑梗死病情程度不同分为大梗死组、中梗死组、小梗死组,依据患者神经功能受损程度分为重度组、中度组、轻度组,根据患者预后不同分为预后良好组、预后不良组。比较研究组、对照组基线资料和血清Hcy、hs-CRP及NEFA水平,同时比较研究组各亚组间Hcy、hs-CRP及NEFA水平。结果研究组血清Hcy、hs-CRP及NEFA水平较对照组明显升高(P<0.05),而两组性别、年龄、BMI、吸烟史、饮酒史等基线资料比较差异无统计学意义(P>0.05)。大梗死组、中梗死组、小梗死组血清Hcy、hs-CRP及NEFA水平依次明显降低,差异有统计学意义(P<0.05)。重度组、中度组、轻度组血清Hcy、hs-CRP及NEFA水平依次明显降低,组间两两比较差异有统计学意义(P<0.05)。预后良好组血清Hcy、hs-CRP及NEFA水平较预后不良组明显降低(P<0.05);ROC曲线分析提示血清Hcy、hs-CRP及NEFA水平联合检测诊断脑梗死患者预后的曲线下面积、灵敏度和特异性较三项单独检测的明显提高。结论脑梗死患者血清Hcy、hs-CRP及NEFA水平呈明显升高趋势,且Hcy、hs-CRP及NEFA水平与患者预后密切相关,三者联合检测利于脑梗死患者预后的有效评估。

Objective To investigate the correlation between serum homocysteine(Hcy),high-sensitivity C-reactive protein(hs-CRP)and free fatty acid(NEFA)levels and prognosis in patients with cerebral infarction.Methods A total of 108 patients with cerebral infarction(the study group)who were admitted to the hospital from June,2018 to June,2019 and 70 healthy volunteers(the control group)who underwent physical examination during the same period were enrolled in this study.According to the severity of cerebral infarction,the patients were divided into the large infarction group,medium infarction group and small infarction group.According to the severity of neurological impairment,they were divided into the severe group,moderate group and mild group.According to the prognosis,they were divided into the good prognosis group and poor prognosis group.Baseline data and serum Hcy,hs-CRP and NEFA levels of the study group and the control group were compared.Hcy,hs-CRP and NEFA levels of different subgroups of the study group were also compared.Results Serum Hcy,hs-CRP and NEFA levels in the study group were significantly higher than those in the control group(P<0.05),while there was no significant difference between the two groups for baseline data,such as gender,age/BMI,smoking history and drinking history(P>0.05).Serum Hcy,hs-CRP and NEFA levels in the large infarction group,medium infarction group and small infarction group significantly decreased successively(P<0.05).Serum Hcy,hs-CRP and NEFA levels in the severe group,moderate group and mild group significantly decreased in turn,and differences between any two groups were statistically significant(P<0.05).Serum Hcy,hs-CRP and NEFA levels in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05).ROC curve analysis showed that the area under the curve,sensitivity and specificity of combination of serum Hcy,hs CRP and NEFA for the prognosis of patients with cerebral infarction were significantly higher than those of single-marker tests.Conclusion Serum Hcy,hs-CRP and NEFA in patients with cerebral infarction show a significant increasing trend.In addition,these markers are closely related to the prognosis of patients,and combined detection of these three is conductive to the effective prognosis of patient with cerebral infarction.