脂蛋白相关磷脂酶A2、D-二聚体和降钙素原联合检测在急性脑梗死中的诊断价值

Diagnostic Value of Combined Detection of Lipoprotein-associated Phospholipase A2, D-dimer and Procalcitonin in Acute Cerebral Infarction

目的:探究脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)、D-二聚体(D-dimer,D-D)和降钙素原(procalcitonin,PCT)联合检测在急性脑梗死中的诊断价值。方法:回顾性选取2020年10月-2021年10月阳江市中医医院68例急性脑梗死患者作为观察组,同期68例健康体检者作为对照组。根据NIHSS量表评分将观察组分为重度组(16例),中度组(24例),轻度组(28例)。观察组和对照组均进行Lp-PLA2、D-D、PCT检测。比较四组(对照组和重度组、中度组、轻度组)Lp-PLA2、D-D和PCT水平。分析Lp-PLA2、D-D和PCT及联合检测的诊断效能。结果:重度组、中度组、轻度组Lp-PLA2、D-D和PCT水平均高于对照组(P<0.05);重度组Lp-PLA2、D-D和PCT水平均高于中度组与轻度组(P<0.05),中度组Lp-PLA2、D-D和PCT水平均高于轻度组(P<0.05)。联合检测诊断急性脑梗死的AUC、敏感度和特异度、阳性预测值、阴性预测值均明显高于Lp-PLA2、D-D和PCT单独检测。结论:Lp-PLA2、PCT和D-D在急性脑梗死患者中呈高表达,且三者联合检测能获得较高的诊断效能,能反映患者的疾病严重程度,应予以高度重视。

Objective:To explore the diagnostic value of combined detection of lipoprotein-associated phospholipase A2 (Lp-PLA2),D-dimer (D-D) and procalcitonin (PCT) in acute cerebral infarction.Method:A total of 68 patients with acute cerebral infarction in Yangjiang Hospital of Traditional Chinese Medicine from October 2020 to October 2021 were retrospectively selected as the observation group,and 68 healthy physical examiners in the same period were selected as the control group.The observation group was divided into severe group (16 cases),moderate group (24 cases) and mild group (28 cases) according to the NIHSS scale score.Lp-PLA2,D-D and PCT were detected in the observation group and the control group.The levels of Lp-PLA2,D-D and PCT in the four groups (control group and severe,moderate and mild groups) were compared.The diagnostic efficacy of Lp-PLA2,D-D and PCT and combined detection was analyzed.Result:The levels of Lp-PLA2,D-D and PCT in severe,moderate and mild groups were higher than those in the control group (P<0.05);the levels of Lp-PLA2,D-D and PCT in severe group were higher than those in moderate group and mild group (P<0.05);the levels of Lp-PLA2,D-D and PCT in the moderate group were higher than those in the mild group (P<0.05).The AUC,sensitivity,specificity,positive predictive value and negative predictive value of the combined detection in the diagnosis of acute cerebral infarction were significantly higher than those of the single detection of Lp-PLA2,D-D and PCT.Conclusion:Lp-PLA2,PCT and D-D are highly expressed in patients with acute cerebral infarction,and the combined detection of the three can achieve high diagnostic efficiency and reflect the severity of the disease of patients,which should be paid great attention.