颈动脉血流参数及Lp-PLA2、Hcy在脑梗死诊断中的应用价值

Application Value of Carotid Blood Flow Parameters and Lp-PLA2 and Hcy in the Diagnosis of Cerebral Infarction

目的:探讨颈动脉血流参数及脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)、同型半胱氨酸(homocysteine,Hcy)在脑梗死诊断中的应用价值。方法:回顾性选取2020年1月-2021年12月江阴南闸医院收治的103例脑梗死患者作为观察组,同期选取体检中心健康体检者100例作为对照组。两组均接受多普勒超声检查及血清学检查。比较两组颈动脉血流参数、Lp-PLA2、Hcy水平。分析颈动脉血流参数与Lp-PLA2、Hcy的相关性。分析血流阻力指数(RI)、Lp-PLA2、Hcy及联合检测对脑梗死的诊断效能。结果:观察组收缩期峰值流速(PSV)、舒张期末流速(EDV)均明显低于对照组,RI明显高于对照组(P<0.05)。观察组Lp-PLA2、Hcy水平均明显高于对照组(P<0.05)。根据Pearson相关性分析,PSV、EDV与Lp-PLA2、Hcy均呈负相关,RI与Lp-PLA2、Hcy均呈正相关(P<0.05)。三者联合检测的曲线下面积(AUC)为0.920,敏感度和特异度为92.0%、84.1%。结论:颈动脉血流参数联合Lp-PLA2、Hcy检测有助于脑梗死患者的早期诊断,值得临床推广应用。

Objective:To investigate the application value of carotid blood flow parameters and lipoprotein-associated phospholipase A2 (Lp-PLA2) and homocysteine (Hcy) in the diagnosis of cerebral infarction.Method:A total of 103 patients with cerebral infarction admitted to Jiangyin Nanzha Hospital from January 2020 to December 2021 were retrospectively selected as the observation group,and 100 healthy subjects from the physical examination center were selected as the control group at the same time.Both groups received Doppler ultrasound and serological examination.The carotid blood flow parameters,Lp-PLA2 and Hcy levels were compared between the two groups.The correlation among carotid blood flow parameters and Lp-PLA2 and Hcy was analyzed.The diagnostic efficacy of blood flow resistance index (RI),Lp-PLA2,Hcy and combined detection for cerebral infarction was analyzed.Result:The peak systolic velocity (PSV) and end diastolic velocity (EDV) of the observation group were significantly lower than those of the control group,and the RI was significantly higher than that of the control group (P<0.05).The levels of Lp-PLA2 and Hcy in the observation group were significantly higher than those in the control group (P<0.05).According to Pearson correlation analysis,PSV and EDV were negatively correlated with Lp-PLA2 and Hcy,and RI was positively correlated with Lp-PLA2 and Hcy (P<0.05).The area under curve (AUC) of combined detection of the three was 0.920,and the sensitivity and specificity were 92.0%,84.1%.Conclusion:The detection of carotid blood flow parameters combined with Lp-PLA2 and Hcy is helpful for early diagnosis of cerebral infarction patients,and it is worthy of clinical promotion and application.