血清Hcy、UA、CRP水平与T2DM合并急性脑梗死患者病情的关系分析

Relationship between serum levels of Hcy,UA,CRP and the condition of acute cerebral infarction patients with T2DM

目的探讨血清同型半胱氨酸(Hcy)、尿酸(UA)、C-反应蛋白(CRP)水平与T2DM合并急性脑梗死患者病情的关系分析。方法选取2021年1月-2022年1月在聊城市第二人民医院神经内科和内分泌科住院治疗的130例患者作为研究对象。130例患者中54例T2DM患者为对照组,76例T2DM合并急性脑梗死患者为研究组。同时选取我院体检中心经过体格检查身体健康的体检者50例作为空白组,分别检测血清中Hcy、UA、CRP水平。对76例T2DM合并急性脑梗死患者按照梗死面积及NIHSS评分进行分组,检测Hcy、UA、CRP水平并分析其与梗死面积及NIHSS评分相关性,ROC曲线分析Hcy、UA、CRP对疾病的诊断价值。结果与空白组比较,对照组患者血清中Hcy、UA、CRP水平升高,差异具有意义(P<0.001),与对照组相比,研究组患者血清中Hcy、UA、CRP水平升高,差异具有意义(P<0.001);将研究组按照梗死面积分为A组(<1.5 cm)、B组(1.5~3.0 cm)、C组(>3.0 cm),与A组比较,B组患者梗死面积、血清中Hcy、UA、CRP水平升高,差异具有意义(P<0.05),与B组相比,C组患者梗死面积、血清中Hcy、UA、CRP水平升高,差异具有意义(P<0.05);将研究组按照NIHSS评分进行分组,D组(NIHSS评分≤4分)、E组(4分<NIHSS评分≤5分)、F组(NIHSS评分>5分),与D组比较,E组患者NIHSS评分、血清中Hcy、UA、CRP水平升高,差异具有意义(P<0.05),与E组相比,F组患者NIHSS评分、血清中Hcy、UA、CRP水平升高,差异具有意义(P<0.05);在T2DM合并急性脑梗死患者中Hcy、UA、CRP与患者梗死面积大小、NIHSS评分(均P<0.05);Hcy联合UA联合CRP对T2DM合并急性脑梗死ROC的AUC面积为0.836,联合诊断价值最高。结论血清Hcy、UA、CRP水平随着T2DM的急性脑梗死患者病情的增加而升高,与梗死面积及神经功能损伤相关,联合检测可提高诊断价值。

Objective To investigate the relationship between serum homocysteine(Hcy),uric acid(UA),C-reactive protein(CRP)levels and the disease of acute cerebral infarction patients with T2DM.Methods 130 patients hospitalized in the Department of Neurology and Endocrinology of Liaocheng Second People's Hospital from January 2021 to January 2022 were selected as the study objects.Among the 130 patients,54 T2DM patients were the control group,and 76 T2DM patients with acute cerebral infarction were the study group.At the same time,50 healthy subjects were selected as blank group,and serum levels of Hcy,UA and CRP were detected respectively.Seventy-six T2DM patients with acute cerebral infarction were grouped according to infarct size and NIHSS score.The levels of Hcy,UA and CRP were detected and their correlation with infarct size and NIHSS score was analyzed.The diagnostic value of Hcy,UA and CRP was analyzed by ROC curve.Results Compared with the blank group,the serum levels of Hcy,UA and CRP in the control group were increased with significant differences(P<0.001);compared with the control group,the serum levels of Hcy,UA and CRP in the research group were increased with significant differences(P<0.001);According to the infarct size,they were divided into group A(<1.5 cm),group B(1.5-3.0 cm)and group C(>3.0 cm).Compared with group A,the infarct size,serum Hcy,UA and CRP levels in group B were increased,and the differences were significant(P<0.05).The infarct size,serum Hcy,UA and CRP levels in group C were increased,and the differences were significant(P<0.05).NIHSS score was divided into groups:Group D(NIHSS score≤4 points),group E(4 points<NIHSS score≤5 points)and group F(NIHSS score>5 points).Compared with group D,NIHSS score,serum Hcy,UA and CRP levels in group E were increased,and the differences were significant(P<0.05).The NIHSS score,serum Hcy,UA and CRP levels in group F were increased,and the differences were significant(P<0.05).Hcy,UA,CRP were correlated with infarct size and NIHSS scores in T2DM patients with acute cerebral infarction(all P<0.05).The ROC AUC area of Hcy combined with UA combined with CRP in T2DM patients with acute cerebral infarction was 0.836,indicating the highest diagnostic value.Conclusion Serum Hcy,UA and CRP levels increase with the increase of acute cerebral infarction in T2DM patients,which is related to infarction size and nerve function injury.Combined detection can improve the diagnostic value.