老年脑梗死患者血清ACA、抗β2GP1、Hcy和hs-CRP水平变化及其与疾病严重程度的关系

Changes of serum ACA,anti-β2GP1,Hcy and hs-CRP levels and their relationship with disease severity in elderly patients with cerebral infarction

目的:探讨老年脑梗死患者血清抗心磷脂抗体(ACA)、抗β2糖蛋白1抗体(抗β2GP1)、同型半胱氨酸(Hcy)和超敏C反应蛋白(hs-CRP)水平变化及其与疾病严重程度的关系。方法:选取148例老年脑梗死患者为观察组,根据神经功能缺损(NDS)评分分为轻度组(n=30)、中度组(n=32)及重度组(n=86);另选同期76名体检健康老年人为对照组。比较观察组和对照组及观察组不同病情程度患者的血清ACA、抗β2GP1、Hcy、hs-CRP水平,分析其与疾病严重程度的关系。结果:观察组患者血清ACA、抗β2GP1、Hcy、hs-CRP水平高于对照组(P<0.05)。不同病情程度脑梗死患者血清ACA、抗β2GP1、Hcy、hs-CRP水平比较:重度组>中度组>轻度组(P<0.05)。相关性分析显示,血清ACA、抗β2GP1、Hcy、hs-CRP水平与老年脑梗死患者病情严重程度均呈正相关关系(r=0.636、0.614、0.563、0.571,P<0.05)。ROC曲线分析显示,血清ACA对轻中度与重度的区分有更高的鉴别价值(P<0.05),敏感度和特异性分别为90.70%、87.10%。结论:老年脑梗死患者血清ACA、抗β2GP1、Hcy、hs-CRP水平均升高,且与病情严重程度正相关,可作为鉴别脑梗死严重程度的有效指标。

Objective:To explore the changes of serum anticardiolipin antibody(ACA),anti-β2 glycoprotein 1 antibody(anti-β2GP1),homocysteine(Hcy)and hypersensitive C-reactive protein(hs-CRP)levels in elderly patients with cerebral infarction and the relationship with disease severity.Methods:148 elderly patients with infarction were selected as the observation group.According to the neurological deficit score(NDS),the above patients were classified into mild group(n=30),moderate group(n=32)and severe group(n=86).76 healthy elderly people who underwent physical examination were included in control group.The levels of serum ACA,anti-β2GP1,Hcy and hs-CRP were compared in groups,and the expression characteristics of the above serum factors in elderly patients with cerebral infarction and their relationship with disease progression were analyzed.Results:Compared with control group,the levels of serum ACA,anti-β2GP1,Hcy and hs-CRP in observation group were higher(P<0.05).Serum ACA,anti-β2GP1,Hcy and hs-CRP levels of elderly patients with cerebral infarction in severe group were higher than those in moderate group(P<0.05),and the levels were higher in moderate group than those in mild group(P<0.05).Correlation analysis showed that serum ACA,anti-β2GP1,Hcy and hs-CRP were positively correlated with the severity of elderly patients with cerebral infarction(r=0.636,0.614,0.563,0.571,P<0.05).ROC curve analysis showed that serum ACA had a more obvious distinguishing value for the distinction between mild-to-moderate disease and severe disease,and its sensitivity and specificity were 90.70%and 87.10%,respectively.Conclusion:The levels of serum ACA,anti-β2GP1,Hcy and hs-CRP are elevated in elderly patients with cerebral infarction,and are positively correlated with disease severity.They are all highly effective in distinguishing the severity of cerebral infarction.