脑出血患者血液标志物的变化及临床意义

目的：检测脑出血(CH)患者血液标志物的水平，并探讨其临床意义。方法选取2013年1月至2015年4月我院收治的55例CH患者作为CH组，随机选取同期在我院做健康体检的49例健康人作为对照组。应用全自动生化分析仪日立7600测定两组受检者的血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、尿酸(UA)的水平，sysmexCA8000全自动血凝仪测定血浆D-二聚体(DD)、纤维蛋白原(FIB)水平。比较不同组受检者的血清Hcy、hs-CRP、UA及血浆DD、FIB含量和阳性检出率，并对CH组患者血清Hcy、hs-CRP、UA和血浆DD、FIB之间进行直线相关性分析，以研究血液标志物与CH的内在联系。结果与对照组比较，CH组患者的血清Hcy [(7.30±3.01)μmol/L vs (14.52±6.20)μmol/L]、hs-CRP [(2.30±1.11) mg/L vs (4.24±3.64) mg/L]、UA [(231.50±53.80)μmol/L vs (279.01±98.92)μmol/L]、血浆DD [(0.34±0.15) mg/L vs (0.66±0.53) mg/L]及FIB [(2.17±0.57) g/L vs (2.58±0.86) g/L]比较，CH组患者明显升高，差异均有显著统计学意义(P<0.01))；CH组患者的Hcy与FIB呈正相关(r=0.305，P<0.05)，与hs-CRP、UA、DD无相关性(r=0.012、0.089、0.039，P>0.05)；CH组患者的Hcy、CRP、和DD阳性检出率分别为47.3%(26/55)、40.0%(22/55)和47.3%(26/55)，均明显高于对照组的10.2%(5/49)、4.1%(2/49)和4.1%(5/49)，差异均有统计学意义(P<0.05)。结论 Hcy、CRP、UA、DD、FIB水平与脑出血密切相关；这些标志物可能参与脑出血的发生、发展；五项指标联合检测对CH早期防治均有重要的临床意义。

Change of blood markers in patients with cerebral hemorrhage and its clinical significance

Objective To detect the levels of blood markers such as serum homocysteine (Hcy), high-sensitivi-ty C-reactive protein (hs-CRP), uric acid (UA), plasma D-dimer (D-D) and fibrinogen (FIB) in the patients with cerebral hemorrhage (CH), and to investigate its clinical significance. Methods A total of 55 patients with CH in our hospital from Jan. 2013 to April 2015 were selected as the CH group, and 49 healthy people who underwent healthy physical ex-amination in our hospital during the same period were enrolled as the control group. The levels of serum Hcy, hs-CRP, UA were detected by the HITACHI 7600 fully automatic biochemical analyzer, and the levels of plasma D-D and FIB were determined by the SYSMEX CA8000 fully automatic coagulometer. The Hcy, hs-CRP, UA, plasma D-D, FIB con-tent and positive detection rate of subjects were compared between the two groups. In the CH group, linear correlation analysis was performed between Hcy, hs-CRP, UA and plasma DD, FIB, in order to study the intrinsic link between blood markers and CH. Results The levels of serum Hcy ((7.30 ± 3.01) μmol/L vs (14.52 ± 6.20) μmol/L), hs-CRP ((2.30 ± 1.11) mg/L vs (4.24 ± 3.64) mg/L), UA ((231.50 ± 53.80) μmol/L vs (279.01 ± 98.92) μmol/L), plasma D-dimer ((0.34±0.15) mg/L vs (0.66±0.53) mg/L) and FIB ((2.17±0.57) g/L vs (2.58±0.86) g/L) in the CH group were significant-ly increased compared with the control group (P<0.01). There was significantly positive correlation between Hcy and FIB in the CH group (r=0.305, P<0.05), but there was no significant correlation between Hcy and hs-CRP, UA, plasma D-dimer (r=0.012, 0.089, 0.039, P>0.05). The positive rates of Hcy, CRP and DD in the CH group were significantly higher than those in the control group (47.3%(26/55) vs 10.2%(5/49), 40.0%(22/55) vs 4.1%(2/49), 47.3%(26/55) vs 4.1%(2/49), respectively), and the differences were statistically significant (P<0.05). Conclusion Hcy, CRP, UA, DD, FIB are closely related to cerebral hemorrhage. These markers may be involved in the occurrence and development of ce-rebral hemorrhage. The combined detection of the five indicators has important clinical significance for the early preven-tion and treatment of CH.