脂蛋白(a)联合铁蛋白和在超敏C反应蛋白检测对急性脑梗死的应用价值

目的:通过分析正常人与急性脑梗死患者之间脂蛋白(a)[Lp(a)]、铁蛋白(SF)超敏C反应蛋白(hs-CRP)水平的差异,探讨脂蛋白(a)、铁蛋白和超敏C反应蛋白在不同梗死面积中的相关性。方法:回顾性分析叙永县中医医院2018年1月~2019年12月入院的急性脑梗死患者202例(梗死组)和同期进行健康体检的体检者202例作为对照(对照组),采用免疫透射比浊法测定血清中Lp(a)、电化学发光法测定血清SF水平、乳胶免疫比浊法测定h s-CRP水平。采用日本东芝CT仪对梗死组患者进行头部扫描按不同梗死面积进行分型,比较梗死组和对照组、不同CT分型之间的差异性和相关性,并通过Logistic对Lp(a)、SF、hs-CRP进行危险因素分析。将梗死组和对照组分别随机分为两组各101例,分别纳入测试集和验证集,通过Logistic建立预测模型,验证集进行模型验证,采用受试工作者特征曲线(ROC)判断诊断效能。结果:①梗死组和对照组之间血清Lp(a)、SF、hs-CRP水平差异有统计学意义(P<0.01)。②血清Lp(a)、SF、hs-CRP水平在不同梗死面积分型间的差异肴统计学意义(P<0.01)。③血清Lp(a)、SF、hs-CRP和梗死面积之间存在相关性(P<0.01)。④通过Logistic回归分析Lp(a)、SF、hs-CRP是急性脑梗死的危险因素(P<0.01)。⑤测试集联合检测AUC=0.989,验证集联合检测AUC=0.977(Z=1.166,P>0.05),差异无统计学意义;通过ROC曲线分析得出Lp(a)单独检测时(AUC=0.82,P<0.01)SF单独检测时(AUC=0.874,P<0.01)、超敏CRP单独检测时(AUC=0.958,P<0.01)。结论:脂蛋白(a)、铁蛋白和超敏C反应蛋白是急性脑梗死的危险因素,急性脑梗死患者中血清Lp(a)、SF、hs-CRP水平增高,并且随着梗死面积增大而增加,呈正相关关系,通过联合检测提高了灵敏度和特异性,对于急性脑梗死的诊断具有辅助诊断作用。

Application value of lipoprotein(a)in combination with ferritin and in detection of hypersensitive c-reactive protein in acute cerebral infarction

Objective:To explore the correlation of lipoprotein(a),ferritin and hypersensitive c-reactive protein(hs-crp)indifferent infarcts.Methods:A retrospective analysis were performed A total of 202 patients with acute cerebral infarction admitted to our hospital from January 2018 to December 2019 were devided into infarction group and 202 healthy subjects were selected as the control group,f serum Lp(a)were detected by immune transmission turbidimetric method,serum SF levels were detected by electrochemical luminescence method,The hs-CRP levels were detected by latex immune turbidimetric method.Toshiba CT was used to classify the patients in the infarction group by head scanning according to different infarction areas,to compare the difference and correlation between the infarction group and the control group and different CT types,and to analyze the risk factors of Lp(a),SF and hs-crp by Logistic.The infarction group and control group were randomly divided into two groups with 101 cases each,which were respectively included in the test set and validation set The Logistic prediction model was established,and the validation set was used for model validation.Results:there were statistically significant differences in serum Lp(a),SF and hs-crp between the infarction group and the control group(P<0.01).The differences of serum Lp(a),SF and hs-crp levels in different infarct surface integral types were statistically significant(P<0.01).There was a correlation between serum Lp(a),SF,hs-crp and infarction area(P<0.01).(4)Lp(a),SF and hs-crp were risk factors of acute cerebral infarction(P<0.01).(5)test set combined detection AUC=0.989,verificadon set combined detection AUC=0.977(Z=1.166,P>0.05),the difference was not statistically significant The ROC curve analysis showed that Lp(a)was detected alone(AUC=0.82,P<0.01),SF was detected alone(AUC=0.874,P<0.01),and hypersensitive CRP was detected alone(AUC=0.958,P<0.01).Conclusion:Lipoprotein(a),ferritin and hypersensitive c-reacrive protein is a risk factor for acute cerebral infarction,and acute cerebral infarction in patients with serum Lp(a),SF,hs-CRP leels,and with the increase of infarction area increases,there was a positive correlation betAveen relations,through joint detection can improve the sensitivity and specificity,has auxiliary diagnosis for the diagnosis of acute cerebral infarction.