凝血四项、C反应蛋白、脑钠肽联合同型半胱氨酸检测在急性脑梗死诊断中的应用

The Application of Detection of Coagulation Four Items,C-reactive Protein and Brain Natriuretic Peptide Combined with Homocysteine in the Diagnosis of Acute Cerebral Infarction

目的:探究凝血四项、C反应蛋白(CRP)、脑钠肽(BNP)联合同型半胱氨酸(Hcy)检测在急性脑梗死(ACI)诊断中应用价值。方法:选择2019年3月-2021年5月莆田市涵江医院收治的90例ACI患者为研究组,另纳入60例同期于本院行健康体检的志愿者为对照组。根据神经功能缺损程度将研究组分为轻度组(n=32)、中度组(n=34)、重度组(n=24),对比所有患者的凝血四项、CRP、BNP、Hcy水平,另分析各指标单独及联合检测在ACI中的诊断价值。结果:研究组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)均低于对照组,纤维蛋白原(FIB)、CRP、BNP、Hcy水平均高于对照组,差异有统计学意义(P<0.05);重度组APTT、PT、TT水平均低于中度组及轻度组,FIB、CRP、BNP、Hcy水平均高于中度组及轻度组,差异有统计学意义(P<0.05);凝血四项、CRP、BNP、Hcy联合检测在ACI诊断中敏感度、特异度均高于单独检测(P<0.05)。结论:凝血四项、CRP、BNP、Hcy联合检测在ACI诊断中具有较高的临床应用价值,能够为临床鉴别诊断提供可靠依据。

Objective:To explore the application value of coagulation four items,C-reactive protein (CRP),brain natriuretic peptide (BNP) combined with homocysteine (Hcy) detection in the diagnosis of acute cerebral infarction (ACI).Method:A total of 90 ACI patients admitted to Putian Hanjiang Hospital from March 2019 to May 2021 were selected as the research group,and another 60 volunteers who underwent physical examinations in our hospital during the same period were included as the control group.According to the degree of nerve function defect,the research group was divided into mild group (n=32),moderate group (n=34) and severe group (n=24).The levels of four coagulation items,CRP,BNP,and Hcy were compared in all patients,and the diagnostic value of each index alone and in combination in ACI was analyzed.Result:The activated partial thromboplastin time (APTT),prothrombin time (PT) and thrombin time (TT) in the research group were lower than those in the control group,and the levels of fibrinogen (FIB),CRP,BNP and Hcy were higher than those in the control group,the differences were statistically significant (P<0.05).The levels of APTT,PT and TT in severe group were lower than those in moderate group and mild group,the levels of FIB,CRP,BNP and Hcy were higher than those in moderate group and mild group,and the differences were statistically significant (P<0.05).The sensitivity and specificity of the combined detection of coagulation four items,CRP,BNP,and Hcy in the diagnosis of ACI were higher than those of the single detection (P<0.05).Conclusion:The combined detection of coagulation four items,CRP,BNP and Hcy has high clinical application value in the diagnosis of ACI,and can provide a reliable basis for clinical differential diagnosis.