脑梗塞患者心肌酶谱与D-二聚体变化及其临床价值分析

Changes of Myocardial Enzymes and D-dimer in Patients with Cerebral Infarction and its Clinical Value Analysis

目的研究脑梗塞患者心肌酶谱与D-二聚体(D-D)变化及其临床价值。方法选取2021年5月-2023年2月我院诊治的60例脑梗塞患者作为研究组,另选取同期在我医院体检健康者60名作为对照组,均行D-D及心肌酶谱指标[肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、乳酸脱氢酶(LDH)]测定。比较研究组和对照组、研究组不同病情及预后患者D-D、CK-MB、CK、LDH水平,并分析D-D、CK-MB、CK、LDH水平对脑梗死诊断的价值、病情严重程度的相关性及预后预测价值。结果研究组D-D、CK-MB、CK、LDH水平均高于对照组(P<0.05);重度脑梗塞患者D-D、CK-MB、CK、LDH水平均高于中度、轻度脑梗塞患者,且中度脑梗塞患者D-D、CK-MB、CK、LDH均高于轻度脑梗塞患者(P<0.05);合并心血管不良事件脑梗塞患者D-D、CK-MB、CK、LDH水平均高于未合并心血管不良事件患者脑梗塞(P<0.05);D-D+联合心肌酶谱指标诊断脑梗塞的敏感度、特异度均高于单一D-D、心肌酶谱指标(P<0.05);Pearson相关性分析显示,D-D、CK-MB、CK、LDH水平与脑梗塞病情严重程度呈正相关(P<0.05);ROC曲线分析显示,D-D+心肌酶谱指标检测预测脑梗塞患者预后敏感度、特异度均高于各指标单独检测(P<0.05)。结论脑梗塞患者心肌酶谱、D-D会发生不同程度变化,且随着病情的严重程度,各指标不断升高,而血清心肌酶谱与D-D联合检测可提高对脑梗塞诊断和脑梗塞患者预后的价值。

Objective To study the changes of myocardial enzymes and D-dimer(D-D)in patients with cerebral infarction and its clinical value.Methods A total of 60 patients with cerebral infarction diagnosed and treated in our hospital from May 2021 to February 2023 were selected as the study group.In addition,60 healthy people who underwent physical examination in our hospital during the same period were selected as the control group.D-D and myocardial enzyme spectrum indexes[creatine kinase isoenzyme(CK-MB),creatine kinase(CK),lactate dehydrogenase(LDH)]were measured.The levels of D-D,CK-MB,CK and LDH were compared between the study group and the control group,and the patients with different conditions and prognosis.The value of D-D,CK-MB,CK and LDH levels in the diagnosis of cerebral infarction,the correlation between the severity of the disease and the predictive value of prognosis were analyzed.Results The levels of D-D,CK-MB,CK and LDH in the study group were higher than those in the control group(P<0.05).The levels of D-D,CK-MB,CK and LDH in patients with severe cerebral infarction were higher than those in patients with moderate and mild cerebral infarction,and the levels of D-D,CK-MB,CK and LDH in patients with moderate cerebral infarction were higher than those in patients with mild cerebral infarction(P<0.05).The levels of D-D,CK-MB,CK and LDH in patients with cerebral infarction complicated with cardiovascular adverse events were higher than those in patients with cerebral infarction without cardiovascular adverse events(P<0.05).The sensitivity and specificity of D-D+combined with myocardial enzymes in the diagnosis of cerebral infarction were higher than those of single D-D and myocardial enzymes(P<0.05).Pearson correlation analysis showed that the levels of D-D,CK-MB,CK and LDH were positively correlated with the severity of cerebral infarction(P<0.05).ROC curve analysis showed that the sensitivity and specificity of D-D+myocardial enzyme spectrum index in predicting the prognosis of patients with cerebral infarction were higher than those of each index alone(P<0.05).Conclusion The myocardial enzymes and D-D in patients with cerebral infarction will change to varying degrees,and with the severity of the disease,the indicators will continue to increase,and the combined detection of serum myocardial enzymes and D-D can improve the diagnosis of cerebral infarction and the prognosis of patients with cerebral infarction.