血清TC、MHR和Hcy联合检测对急性脑梗死的诊断价值

Diagnostic value of combined detection of serum TC,MHR and Hcy in acute cerebral infarction

目的 探讨总胆固醇(TC)、单核细胞与高密度脂蛋白胆固醇(HDL-C)比值(MHR)和同型半胱氨酸(Hcy)在急性脑梗死(ACI)患者血清中的表达水平及TC、MHR、Hcy单独及3项指标联合检测对ACI的诊断价值。方法 选取2023年5-8月在该院神经内科诊断为ACI的患者144例作为病例组,另随机选取同期该院收治的非脑血管疾病患者83例作为对照组。收集并比较所有研究对象的入院资料各项数据[白细胞计数(WBC)、中性粒细胞计数(NEUT)、淋巴细胞计数(LY)、单核细胞计数(MONO)];记录生化全套检测数据[TC、甘油三酯(TG)、HDL-C、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、空腹血糖(FPG)和Hcy],计算MHR,比较两组临床数据及化验结果。采用多因素Logistic回归进行ACI的危险因素分析,绘制受试者工作特征(ROC)曲线评估判断各项指标对ACI的诊断价值。结果 两组吸烟史、饮酒史、WBC、TG和FPG水平比较,差异均无统计学意义(P>0.05)。病例组男性比例、年龄、高血压比例、2型糖尿病比例均大于对照组,差异均有统计学意义(P<0.05)。病例组NEUT、MONO、TC、LDL-C、UA、Hcy水平和MHR均明显高于对照组,LY和HDL-C水平均低于对照组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高血压、年龄≥69岁、Hcy≥15.3μmol/L、TC≥4.76μmol/L和MHR≥0.43是ACI发生的独立危险因素(P<0.05)。ROC曲线分析结果显示,Hcy、TC、MHR诊断ACI的曲线下面积分别为0.859、0.752、0.799,低于3项联合诊断的0.957。结论 TC、MHR和Hcy是ACI发生的独立危险因素,3项指标联合检测对ACI具有较高的诊断价值和临床意义。

Objective To investigate the serum levels of total cholesterol(TC),monocyte to high density lipoprotein cholesterol(HDL-C) ratio(MHR) and homocysteine(Hcy) in patients with acute cerebral infarction(ACI) and the diagnostic value of TC,MHR and Hcy along and combined detection of the 3 indicators for ACI.Methods A total of 144 patients diagnosed with ACI in the Department of Neurology of the hospital from May to August 2023 were selected as the case group,and 83 patients without cerebrovascular disease and physical examination in the hospital during the same period were randomly selected as the control group.The admission data[white blood cell count(WBC),neutrophil count(NEUT),lymphocyte count(LY),monocyte count(MONO)] of all subjects were collected and compared.Biochemical test data [TC,triglyceride(TG),HDL-C,low density lipoprotein cholesterol(LDL-C),uric acid(UA),fasting plasma glucose(FPG) and Hcy] were recorded,and the MHR was calculated.The clinical data and laboratory results of the two groups were compared.Multivariate Logistic regression was used to analyze the risk factors of ACI,and the receiver operating characteristic(ROC) curve was drew to evaluate the diagnostic value of each index for ACI.Results There was no significant difference in smoking history,drinking history,WBC,TG and FPG level between the two groups(P>0.05).The proportion of males,age,proportion of hypertension and proportion of type 2 diabetes in the case group were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of NEUT,MONO,TC,LDL,UA,Hcy and MHR in the case group were significantly higher than those in the control group,and the levels of LY and HDL-C were lower than those in the control group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that hypertension,age ≥69 years old,Hcy≥15.30 μmol/L,TC≥4.76 μmol/L and MHR≥0.43 were independent risk factors for the occurrence of ACI(P<0.05).ROC curve analysis showed that the area under the curve of Hcy,TC,and MHR in the diagnosis of ACI were 0.859,0.752,and 0.799 respectively,which were lower than 0.957 of the 3 combined diagnosis.Conclusion The TC,MHR and Hcy are independent risk factors for ACI,and the combined detection of these 3 indicators has high diagnostic value and clinical significance for ACI.