脂蛋白（a）、总胆汁酸联合检测对急性脑梗死诊断的应用研究

目的主要研究对急性脑梗死患者的血清脂蛋白（a）、总胆汁酸水平同时进行联合检测，以对其病情程度做出准确判断，并可由所得数据进行急性脑梗死与其他脑血管疾病的鉴别诊断。方法利用我科的罗氏日立全自动生化分析仪PPI，采购朗道公司提供的进口试剂，对于研究期间在我院就诊和住院的急性脑梗死患者、急性脑出血患者、健康查体者清晨用普通管空腹抽取静脉血进行脂蛋白（a）和总胆汁酸的分组检测。所得数据采用SPSS统计软件包进行统计学分析，各计量数据均为（x±s）表示，两组间比较用t检验。结果通过研究发现急性脑梗死患者血清内的脂蛋白（a）和总胆汁酸水平较正常人群及脑出血对照组明显增高，两者比较差异有统计学意义（P〈0．01或P〈0．05），不同梗死面积的患者血清内的脂蛋白（a）和总胆汁酸水平比较，呈现大梗死组〉小梗死组〉腔隙性梗死组的趋势，组间比较差异有统计学意义（P〈0．05或P〈0．01）。结论脂蛋白（a）和总胆汁酸两者水平联合检测可以对急性脑梗死患者提供更加准确快速的诊断，提高诊断阳性率。说明了脂蛋白（a）和总胆汁酸在急性脑梗死的发生发展中起着重要作用，且与病情的严重程度、梗死面积呈正相关。

Application of Combined Detection of Lipoprotein (a) and Total Bile Acid in the Diagnosis of Acute Cerebral Infarction

Objective To investigate the application of combined detection of serum lipoprotein(a) and total bile acid in patients with acute cerebral infarction to make accurate judgments of the state of an illness and to make differential diagnosis of acute cerebral infarction and other cerebral vascular disease based the obtained data. Methods Fasting hemospasia samples were harvested by the common tube in the morning from three groups in patients with acute cerebral infarction who visiting hospital and hospitalize in our hospital, patients with acute cerebral hemorrhage who visiting hospital and hospitalize in our hospital and healthy physical examinees to determine the levels of serum lipoprotein (a)and total bile acid by Roche Hitachi automatic biochemistry analyzer PPI and imported reagent of Randox company. The obtained data was analyzed by means of SPSS software. The data were expressed as (-x) ± s, and measured by t test. Results Compared with patients with acute cerebral hemorrhage control group and healthy physical examinees control group, the serum lipoprotein (a) and total bile acid levels in acute cerebral infarction group increased significantly. There were significant difference between them (P＜ 0. 01 or P＜ 0. 05). The serum lipoprotein (a)and total bile acid levels were different among various infarct size groups, large infarct size group ＞ small infarct size group ＞ lacunar infarction group. There were significant difference among three groups (P＜ 0. 05 or P＜ 0. 01). Conclusion Combined detection of lipoprotein(a)and total bile acid can provide more accurate and quick diagnosis and can increase diagnosis positive rate. It shows that the serum lipoprotein(a) and total bile acid play an important role in the development of acute cerebral infarction, and the serum lipoprotein(a) and total bile acid exhibit a positive correlation with severity of disease and infarct size.