首页> 中文期刊> 《中国全科医学》 >血浆大内皮素1与D-二聚体联合检测对急性缺血性脑卒中再出血的预测价值

血浆大内皮素1与D-二聚体联合检测对急性缺血性脑卒中再出血的预测价值

摘要

Objective To analyze the predictive value of combined detection of the plasma big endothelin - 1 (Big ET - 1)and D - Dimer on rehemorrhage in patients with acute ischemic stroke. Methods 120 patients with acute ischemic stroke admitted to People's Hospital of Qihe County from January 2012 to December 2013 were selected. The D - Dimer,PT, INR and PLT levels were tested the second day after hospitalization. ELISA was used to test Big ET - 1. After discharge,the pa-tients were followed up for three months,and the cases of rehemorrhage was recorded. The patients were then divided into hemor-rhage group and control group based on the rehemorrhage status. The Big ET - 1,D - Dimer,PLT,PT and INR levels of the two groups were compared. Logistic regression analysis was used to analyze the influencing factors for rehemorrhage. The best cutoff points of Big ET - 1 and D - Dimer for predicting rehemorrhage were confirmed by the areas under the receiver operating curve (ROC). Results The sex,age and BMI of the hemorrhage group(54 cases)and control group(66 cases)showed no statis-tically significant difference(χ2sex = 0. 412,tage = 1. 027,t'BMI = 1. 358,P > 0. 05). The PLT,PT and INR levels of the two groups showed no statistically significant difference( P > 0. 05). The levels of Big ET - 1 and D - Dimer in the hemorrhage group were both higher than those of the control group(t = 3. 175,3. 629,P 0.05)。出血组和对照组 PLT、PT 及 INR 比较,差异均无统计学意义(P >0.05);出血组血浆Big ET -1和D - Dimer水平均高于对照组(t =3.175、3.629,P <0.05)。多因素 Logistic 回归分析结果显示,血浆Big ET -1和D - Dimer是急性缺血性脑卒中再出血的危险因素(P <0.05)。Big ET -1和D - Dimer预测急性缺血性脑卒中再出血的 ROC 曲线下面积分别为0.804和0.665。但当 Big ET - l≥1.42 pmol/ L 和D - Dimer≥0.68 mg/ L 为切点,对判断再出血的灵敏度为43.8%,特异度为75.2%,准确度为57.4%,ROC 曲线下面积为0.857。结论血浆Big ET -1与D - Dimer联合检测对急性缺血性脑卒中再出血具有较好的预测价值。

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