动脉粥样硬化性脑梗死患者血浆Hcy、hs-CRP、Cys-C及D-二聚体联合检测分析
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摘要
目的探讨动脉粥样硬化性脑梗死患者血浆同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、胱抑素C (Cys-C)及D-二聚体联合检测的价值。方法对85例动脉粥样硬化性脑梗死患者(分为无斑块组及有斑块组,后者又分为稳定斑块组及不稳定斑块组)及80例健康体检者进行血浆Hcy、hs-CRP、Cys-C、D-二聚体浓度测定及神经功能评分。结果 Hcy、hs-CRP、Cys-C及D-二聚体浓度在动脉粥样硬化性脑梗死组中均高于对照组,有斑块组高于无斑块组,不稳定斑块组高于稳定斑块组,差异均有统计学意义(均P<0.05);4种指标浓度均与脑梗死严重程度呈正相关;4种指标联合测定的阳性率远高于单项测定的阳性率。结论血浆Hcy、hs-CRP、Cys-C及D-二聚体水平与动脉粥样硬化性脑梗死病情发展及诊断相关,4种指标联合测定对于动脉粥样硬化性脑梗死诊断具有较高的临床价值。
Objective To investigate the changes and clinical significance of plasma Hcy(homocysteine), hs-CRP(hypersensitive C-reactive protein), Cys-C(cystatin C) and D-dimer in patients with atherosclerotic cerebral infarction.Methods Plasma Hcy, hs-CRP, Cys-C, D-dimer concentrations and neurological function scores were measured in 85 patients with atherosclerotic cerebral infarction(divided into plaque-free group and plaque-containing group, the latter divided into stable plaque group and unstable plaque group) and 80 healthy subjects.Results The concentration levels of Hcy, hs-CRP, Cys-C and D-dimer in atherosclerotic cerebral infarction group were higher than those in the control group, with plaque group higher than without plaque group, unstable plaque group higher than stable plaque group, the differences were statistically significant(P<0.05).The four concentration levels were positively correlated with the severity of cerebral infarction.The positive rate of four combined tests was much higher than that of single test.Conclusion Plasma Hcy, hs-CRP, Cys-C and D-dimer levels are related to the development and diagnosis of atherosclerotic cerebral infarction.The combined determination of four items has high clinical value for the diagnosis of atherosclerotic cerebral infarction.
Objective To investigate the changes and clinical significance of plasma Hcy(homocysteine), hs-CRP(hypersensitive C-reactive protein), Cys-C(cystatin C) and D-dimer in patients with atherosclerotic cerebral infarction.Methods Plasma Hcy, hs-CRP, Cys-C, D-dimer concentrations and neurological function scores were measured in 85 patients with atherosclerotic cerebral infarction(divided into plaque-free group and plaque-containing group, the latter divided into stable plaque group and unstable plaque group) and 80 healthy subjects.Results The concentration levels of Hcy, hs-CRP, Cys-C and D-dimer in atherosclerotic cerebral infarction group were higher than those in the control group, with plaque group higher than without plaque group, unstable plaque group higher than stable plaque group, the differences were statistically significant(P<0.05).The four concentration levels were positively correlated with the severity of cerebral infarction.The positive rate of four combined tests was much higher than that of single test.Conclusion Plasma Hcy, hs-CRP, Cys-C and D-dimer levels are related to the development and diagnosis of atherosclerotic cerebral infarction.The combined determination of four items has high clinical value for the diagnosis of atherosclerotic cerebral infarction.
引文
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[12] 周国庆,李爽,姜友珍.联合检测Hcy、D-二聚体和CRP对老年急性脑梗死的诊断价值[J].实验与检验医学,2013,31(2):164-165.
[13] 陆扬光,HCY、hs-CRP、D-D联合检测在急性脑血管病诊断中的临床意义[J].中国农村卫生,2013,z1:72-73.
[2] 金萍,陈涛,石秀娥,等.外周血指标联合彩超检查在动脉粥样硬化性脑梗死中的应用研究[J].国际检验医学杂志,2017,38(11):1527-1529.
[3] 许媛媛,孙中武.老年脑小血管病患者血浆纤维蛋白原和D-二聚体及同型半胱氨酸水平变化[J].中华老年医学杂志,2017,36(4):382-386.
[4] 中华神经科学会,中华神经外科学会.脑血管病疾病分类[J].中华神经科杂志,1996,29(6):376.
[5] Hinkle J L.Reliability and validity of the National Institutes of Health Stroke Scale for neuroscience nurses[J].Stroke,2014,45(3):e32-34.
[6] 许寅宏,徐恩.血清同型半胱氨酸与脑梗死患者颈动脉粥样硬化斑块稳定性的关系[J].中风与神经疾病杂志,2014,31(7):603-604.
[7] 潘锦华,丁纯.C反应蛋白在老年脑梗死中检测的临床价值分析[J].中国实验诊断学,2014,18(11):1816-1818.
[8] 肖雅娟.血清胱抑素C、同型半胱氨酸与急性脑梗死及长期预后的相关性[J].国际老年医学杂志,2015,36(2):62-63.
[9] 石群,胱抑素 C 与急性脑梗死患者病情严重程度及肾功能变化的关系[J].国际检验医学杂志,2015,36(14):2077-2080.
[10] 陈涛,王应良,王一萍,等.胱抑素C、同型半胱氨酸、超敏C反应蛋白和D-二聚体联合检测动脉粥样硬化性脑梗死的临床意义[J].中国临床神经科学,2013,21(5):562-565.
[11] 邓斌,杜小鹏.急性脑梗死患者血清同型半胱氨酸、高敏C反应蛋白及D-二聚体水平的变化[J].检验与临床,2011,49(32):77-78.
[12] 周国庆,李爽,姜友珍.联合检测Hcy、D-二聚体和CRP对老年急性脑梗死的诊断价值[J].实验与检验医学,2013,31(2):164-165.
[13] 陆扬光,HCY、hs-CRP、D-D联合检测在急性脑血管病诊断中的临床意义[J].中国农村卫生,2013,z1:72-73.