Hcy、hs-CRP、MPO和IMA多指标联合检测与脑血管造影的相关性研究
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摘要
目的探讨同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、髓过氧化物酶(MPO)及缺血修饰蛋白(IMA)多指标联合检测与脑血管造影的相关性。方法回顾性选择2017年1月至2018年6月治疗的脑血管病患者57例,设为观察组;所有患者均经脑血管造影确诊,根据脑血管造影结果分为轻度狭窄组、中度狭窄组与重度狭窄组;选择同期入院健康体检者49例,设为对照组。采用全自动生化分析仪测定各组Hcy与hs-CRP水平;采用酶联免疫吸附试验完成各组MPO及IMA水平测定;采用SPSS Pearson相关性分析软件对Hcy、hs-CRP、MPO及IMA与脑血管造影进行相关性分析;绘制ROC曲线分析Hcy、hs-CRP、MPO及IMA在脑血管病中的诊断效能。结果观察组Hcy、hs-CRP、MPO及IMA水平均高于对照组(P <0. 05);轻度狭窄组Hcy、hs-CRP、MPO及IMA水平,均低于中度狭窄组与重度狭窄组(P <0. 05); SPSS Pearson相关性分析结果表明:脑血管病患者Hcy、hs-CRP、MPO及IMA表达水平与脑血管造影呈正相关性(P <0. 05); Hcy、hs-CRP、MPO及IMA联合检测在脑血管病患者中的诊断敏感度、特异度高于单一Hcy、hs-CRP、MPO及IMA(P <0. 05)。结论 Hcy、hs-CRP、MPO及IMA多指标联合检测与脑血管造影存在明显相关性,用于脑血管病患者中能获得较高的诊断效能。
Objective To investigate the correlation between combined detection of homocysteine( Hcy),hypersensitive C-reactive protein( hs-CRP),myeloperoxidase( MPO) and ischemic modification protein( IMA) with cerebral angiography. Methods A total of 57 patients with cerebrovascular disease treated from January to May 2018 were enrolled in the observation group and all patients were diagnosed by cerebral angiography and classified into mild stenosis,moderate stenosis and severe stenosis group according to cerebral angiography. 49 patients who were admitted to the hospital for healthy physical examination at the same time were set as the control group. The levels of Hcy and hs-CRP in each group were determined by automatic biochemical analyzer. The levels of MPO and IMA in each group were determined by enzyme-linked immunosorbent assay. Hcy,hs-CRP,MPO,IMA and brain were analyzed by SPSS Pearson correlation analysis software. Angiography was performed for correlation analysis; ROC curve was drawn to analyze the diagnostic efficacy of Hcy,hs-CRP,MPO and IMA in cerebrovascular disease. Results The levels of Hcy,hs-CRP,MPO and IMA in the observation group were higher than those in the control group( P < 0. 05). The levels of Hcy,hs-CRP,MPO and IMA in the mild stenosis group were lower than those in the moderate and severe stenosis group( P < 0. 05); SPSS Pearson correlation analysis showed that the expression levels of Hcy,hs-CRP,MPO and IMA in cerebrovascular disease were positively correlated with cerebral angiography results( P < 0. 05); The diagnostic sensitivity and specificity of combined detection in patients with cerebrovascular disease were higher than single index( P < 0. 05). Conclusion The combined detection of multiple indicators of Hcy,hs-CRP,MPO and IMA has a significant correlation with cerebral angiography,which can be used for the diagnosis of cerebrovascular disease.
Objective To investigate the correlation between combined detection of homocysteine( Hcy),hypersensitive C-reactive protein( hs-CRP),myeloperoxidase( MPO) and ischemic modification protein( IMA) with cerebral angiography. Methods A total of 57 patients with cerebrovascular disease treated from January to May 2018 were enrolled in the observation group and all patients were diagnosed by cerebral angiography and classified into mild stenosis,moderate stenosis and severe stenosis group according to cerebral angiography. 49 patients who were admitted to the hospital for healthy physical examination at the same time were set as the control group. The levels of Hcy and hs-CRP in each group were determined by automatic biochemical analyzer. The levels of MPO and IMA in each group were determined by enzyme-linked immunosorbent assay. Hcy,hs-CRP,MPO,IMA and brain were analyzed by SPSS Pearson correlation analysis software. Angiography was performed for correlation analysis; ROC curve was drawn to analyze the diagnostic efficacy of Hcy,hs-CRP,MPO and IMA in cerebrovascular disease. Results The levels of Hcy,hs-CRP,MPO and IMA in the observation group were higher than those in the control group( P < 0. 05). The levels of Hcy,hs-CRP,MPO and IMA in the mild stenosis group were lower than those in the moderate and severe stenosis group( P < 0. 05); SPSS Pearson correlation analysis showed that the expression levels of Hcy,hs-CRP,MPO and IMA in cerebrovascular disease were positively correlated with cerebral angiography results( P < 0. 05); The diagnostic sensitivity and specificity of combined detection in patients with cerebrovascular disease were higher than single index( P < 0. 05). Conclusion The combined detection of multiple indicators of Hcy,hs-CRP,MPO and IMA has a significant correlation with cerebral angiography,which can be used for the diagnosis of cerebrovascular disease.
引文
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[10]刘少平,韩利蓉,余卉,等.急性脑梗死血清Hcy、hs_CRP及NSE的水平变化[J].心脑血管病防治,2016,16(2):127-128.
[11]Balestrino M,Sarocchi M,Adriano E,et al.Potential of creatine or phosphocreatine supplementation in cerebrovascular disease and in ischemic heart disease[J].Amino Acids,2016,48(8):1-13.
[12]薛有平,雷毅,刘峰,等.Hcy、IMA、MPO、hs-CRP与脑血管病患者病变程度的相关性分析[J].临床和实验医学杂志,2018,17(4):376-379.
[13]李玉敏,齐振生,姚淑艳,等.HCY、DD与hs-CRP等生化指标在冠心病诊断价值的探讨[J].中国实验诊断学,2016,20(4):646-649.
[14]张晓慧.中西医结合治疗对原发性高血压患者血清UA、Hcy、hsCRP及血脂水平的影响[J].现代中西医结合杂志,2016,25(7):733-735.
[15]韩玮,於四军,罗建平,等.急性冠脉综合征患者血清SCD40 L、Periostin、IMA、PAI-1水平改变以及心功能的研究[J].临床和实验医学杂志,2016,15(14):1377-1380.
[2]陈小真,戎亦骊,马全鑫,等.糖尿病ZDF大鼠早期微血管并发症的生化指标及病理组织学变化[J].中国比较医学杂志,2016,26(5):63-70.
[3]Inzucchi SE,Viscoli CM,Young LH,et al.Pioglitazone Prevents Diabetes in Patients With Insulin Resistance and Cerebrovascular Disease.[J].Diabetes Care,2016,39(10):1684.
[4]常海刚,金保哲,马鹏举,等.丙戊酸钠降低蛛网膜下腔出血大鼠超敏C反应蛋白水平及减轻脑损伤用研究[J].中华神经医学杂志,2016,15(2):136-139.
[5]欧阳玉立,鲍曼.Hcy、hsCRP、LP(a)和D-D联合检测在冠心病诊断中的应用价值[J].江苏医药,2016,42(9):1074-1075.
[6]各类脑血管疾病诊断要点(1995)[J].临床和实验医学杂志,2013,12(7):559.
[7]马学华,宋志伟,叶向梅,等.MPO对急性冠脉综合征早期筛查的临床意义[J].标记免疫分析与临床,2016,23(9):973-976.
[8]杨舒畅,徐国栋.急性脑梗死患者血Hcy、hsCRP、v WF、NSE水平分析[J].心血管康复医学杂志,2016,25(6):623-625.
[9]翟向伟,高宏勇,王燕妮,等.冠心病病程中联合检测HCY、h S-CRP、LP(a)及D-二聚体的临床意义[J].陕西医学杂志,2017,46(10):1479-1481.
[10]刘少平,韩利蓉,余卉,等.急性脑梗死血清Hcy、hs_CRP及NSE的水平变化[J].心脑血管病防治,2016,16(2):127-128.
[11]Balestrino M,Sarocchi M,Adriano E,et al.Potential of creatine or phosphocreatine supplementation in cerebrovascular disease and in ischemic heart disease[J].Amino Acids,2016,48(8):1-13.
[12]薛有平,雷毅,刘峰,等.Hcy、IMA、MPO、hs-CRP与脑血管病患者病变程度的相关性分析[J].临床和实验医学杂志,2018,17(4):376-379.
[13]李玉敏,齐振生,姚淑艳,等.HCY、DD与hs-CRP等生化指标在冠心病诊断价值的探讨[J].中国实验诊断学,2016,20(4):646-649.
[14]张晓慧.中西医结合治疗对原发性高血压患者血清UA、Hcy、hsCRP及血脂水平的影响[J].现代中西医结合杂志,2016,25(7):733-735.
[15]韩玮,於四军,罗建平,等.急性冠脉综合征患者血清SCD40 L、Periostin、IMA、PAI-1水平改变以及心功能的研究[J].临床和实验医学杂志,2016,15(14):1377-1380.