D-D、MMP-9及Lp-PLA2联合检测用于脑梗死诊断的敏感度与特异性分析-东南大学学报医学版

D-D、MMP-9及Lp-PLA2联合检测用于脑梗死诊断的敏感度与特异性分析

单位：河南省红十字血液中心, 河南郑州 450012

分类号：R743.33

出版年·卷·期（页码）：2018·37·第二期（277-281）

摘要：

目的：探讨血浆D-二聚体（D-D）、基质金属蛋白酶-9（MMP-9）、脂蛋白相关磷脂酶A2（Lp-PLA2）联合检测用于脑梗死诊断的敏感度与特异性分析。方法：将2014年3月至2016年5月在我院确诊的64例脑梗死患者纳入观察组，并选同期64例健康体检者纳入对照组，比较D-D、MMP-9、Lp-PLA2在两组受试者中的表达水平差异，并与受试者的美国国立卫生院神经功能缺损评分（NIHSS）进行相关性分析，采用受试者工作特征曲线（ROC）分析单独诊断、联合诊断敏感度及特异性。结果：观察组与对照组在D-D[（779.1±163.5）μg·L^-1 vs（117.3±52.5）μg·L^-1]、MMP-9[（264.4±35.8）μg·L^-1 vs（55.3±7.6）μg·L^-1]、Lp-PLA2[（28.7±10.2） nmol·L^-1 vs（11.9±6.4） nmol·L^-1]表达水平上差异具有统计学意义（P<0.05），NIHSS与D-D （r=0.462）、MMP-9（r=0.493）、Lp-PLA2（r=0.592）均存在相关性，D-D、MMP-9、Lp-PLA2三者联用的敏感度（90.6%）、特异性（86.7%）、约登指数（0.77）及曲线下面积（0.898）均高于单独指标或两两指标联用。结论：D-D、MMP-9及Lp-PLA2联合检测有利于提高脑梗死诊断的准确度。

Objective:To investigate the sensitivity and specificity of plasma D-dimer (D-D), matrix metalloproteinase-9 (MMP-9) and lipoprotein-related phospholipase A2 (Lp-PLA2) in the diagnosis of cerebral infarction. Methods:64 patients with cerebral infarction diagnosed in our hospital from March 2014 to May 2016 were enrolled in the observation group and 64 healthy subjects were included in the control group. The expression levels of DD, MMP-9 and Lp-PLA2 in the two groups of subjects were compared, and the relationships between the expression of DD, MMP-9, Lp-PLA2 and the NIHSS were analyzed and the sensitivity and specificity of individual diagnosis, combined diagnosis were analyzed by the use of the patient's characteristic curve (ROC). Results:There were significant differences between the observation group and the control group in the expression levels of DD[(779.1±163.5)μg·L^-1 vs (117.3±52.5)μg·L^-1], MMP-9[(264.4±35.8)μg·L^-1 vs (55.3±7.6)μg·L^-1] and Lp-PLA2[(28.7±10.2)nmol·L^-1 vs (11.9±6.4)nmol·L^-1]. There was a correlation between NIHSS and D-D (r=0.462), MMP-9 (r=0.493) and Lp-PLA2 (r=0.592). The sensitivity (90.6%), specificity(86.7%), Jorden index (0.77) and area under the curve (0.898) of the three joint diagnosis were higher than those of the individual index or the two indicators. Conclusion:D-D, MMP-9 and Lp-PLA2 joint detection can improve the accuracy of cerebral infarction diagnosis.

参考文献：

[1] 赵红梅,刘文华,王筱萌,等.复发性脑梗死的危险因素及病因学分析[J].中华老年心脑血管病杂志,2013,15(1):42-45.
[2] 顾汉沛,王光胜,葛剑青.血浆脂蛋白相关磷脂酶A2与脑梗死复发的相关性分析[J].临床神经病学杂志,2016,29(4):290-292.
[3] 王璇,吴成吉,董淑欣,等.胱抑素C与基质金属蛋白酶9在急性脑梗死中临床价值的探讨[J].中国实验诊断学,2015,19(7):1062-1064.
[4] 曹风华,吴正福,陈鹏,等.急性脑梗死患者血清同型半胱氨酸,D-二聚体和神经元特异性烯醇化酶水平的变化及其临床意义[J].现代生物医学进展,2014,14(3):542-544.
[5] 王薇薇,王新德.第六届全国脑血管病学术会议纪要[J].中华神经科杂志,2004,37(4):346-348.
[6] SIEGLER J E,BOEHME A K,KUMAR A D,et al.What change in the National Institutes of Health Stroke Scale should define neurologic deterioration in acute ischemic stroke?[J].Journal of Stroke and Cerebrovascular Diseases,2013,22(5):675-682.
[7] HU J,WEN Q,WU Y,et al.The effect of butylphthalide on the brain edema,blood-brain barrier of rats after focal cerebral infarction and the expression of Rho A[J].Cell Biochemistry and Biophysics,2014,69(2):363-368.
[8] 祁瑞芳.老年脑梗死患者高同型半胱氨酸血症,氧化应激及炎性反应的相关性[J].中国老年学杂志,2014,34(8):2070-2071.
[9] RIBA-LLENA I,PENALBA A,PELEGRí D,et al.Role of lipoprotein-associated phospholipase A 2 activity for the prediction of silent brain infarcts in women[J].Atherosclerosis,2014,237(2):811-815.
[10] ZHANG P,NIU X L,GUI Y K,et al.The risk factors for leukoaraiosis in patients with cerebral infarction[J].Int J Clin Exp Med,2016,9(2):5089-5095.
[11] WEI H,WANG S,ZHEN L,et al.Resveratrol attenuates the blood-brain barrier dysfunction by regulation of the MMP-9/TIMP-1 balance after cerebral ischemia reperfusion in rats[J].Journal of Molecular Neuroscience,2015,55(4):872-879.
[12] 王从平,曾艳,吴克梅,等.急性脑梗死患者血清MMP-9和D-二聚体水平及与传统危险因素的相关性分析[J].中国实用神经疾病杂志,2016,19(15):42-44.
[13] 李明.血清同型半胱氨酸,血浆内皮素-1,B型利钠肽及D-二聚体联合检测对急性脑梗死的诊断价值[J].实用临床医药杂志,2015,19(1):23-25.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录