高血压伴脑出血患者血浆生物标志物水平的临床研究

摘要

目的：探讨高血压伴脑出血患者血浆生物标志物水平的临床意义。方法采用生物化学分析和放射免疫分析186例高血压伴脑出血、167例单纯高血压、86例单纯高血压血压控制正常患者和65名正常对照组血浆LP(a)、HCY、D-D和CRP水平并进行对比性分析。利用受试者工作特征曲线（ROC曲线）评价生物标志物LP(a)、HCY、D-D和CRP预测单纯高血压向高血压伴脑出血转化时的性能评估价值。结果高血压伴脑出血患者血浆LP(a)、HCY和CRP水平较之单纯高血压明显增高，差异有统计学意义（P均＜0.01），血浆D-D水平差异无统计学意义（P＞0.05），并随颈动脉狭窄率的增加而增高。ROC曲线显示：HCY和CRP具有单纯高血压向高压伴脑出血转化时的诊断价值，并以HCY为最佳。结论血浆HCY和CRP水平是评价单纯高血压向高血压伴脑出血转化时的有价值指标。%ObjectiveTo explore the clinical signifi cance of plasma biomarkers levels in the patients with hypertensive cerebral hemorrhage.Methods Plasma LP(a), HCY, D-D and CRP levels were determined in 186 patients with hypertensive cerebral hemorrhage, 167 patients with simple hypertension, 86 patients with simple hypertension (blood pressure normal with medication) and 65 controls by biochemistry and radioimmunoassay and compared analysis was done as well. The receiver operating characteristic (ROC) curve was plotted to analyze LP(a), HCY, D-D and CRP as a prognostic clinical value indicator of simple hypertension transfer to hypertensive cerebral hemorrhage.Results Plasma LP(a), HCY and CRP levels in patients with hypertensive cerebral hemorrhage were significantly higher than those in patients with simple hypertension (P<0.01), but the D-D level was not signifi cantly different (P>0.05), and increased with IMT severity. ROC curve also showed that two indexes had diagnosis value in simple hypertension transfered to hypertensive cerebral hemorrhage and HCY was excellent.Conclusion Plasma HCY and CRP levels were valuable indexes to predict simple hypertension transfer to hypertension cerebral hemorrhage.