脑梗死与脑出血患者相关生化指标水平差异及临床意义

摘要

目的 探讨急性发作期脑梗死与脑出血患者相关生化指标水平差异及临床意义.方法 选取脑梗死急性发作期患者41例(脑梗死组),脑出血急性发作期患者33例(脑出血组),均检测血浆三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、脂蛋白(a)[LP(a)]、血糖(GLU)、C反应蛋白(CRP)、尿酸(UA)、视黄醇结合蛋白(RBP)和同型半胱氨酸(HCY)指标水平,比较其是否具有显著性差异,并对上述相关生化指标水平绘制ROC曲线,判断对脑梗死与脑出血的诊断价值.结果 脑梗死组血浆TG,LDL,UA和RBP水平明显高于脑出血组,差异均有统计学意义(t=2.0～4.36,均P＜0.05);脑梗死组血浆GLU和CRP水平明显低于脑出血组,差异有统计学意义(t=2.99,2.87,均P＜0.05);而脑梗死组血浆TC,LP(a),HCY水平与脑出血组差异无统计学意义(t=0.95～1.85,均P＞0.05).血浆TG,LDL,UA,GLU,CRP和RBP水平受试者工作特征(ROC)曲线判断脑梗死的曲线下面积(AUC)分别为0.648,0.652,0.783,0.728,0.749和0.649,对脑梗死的判断差异均有统计学意义(均P＜0.05).血浆UA,GLU和CRP水平受试者工作特征ROC曲线判断脑出血的曲线下面积AUC分别为0.706,0.804和0.837,对脑出血的判断差异均有统计学意义(均P＜0.05).结论 相关生化指标水平在脑梗死与脑出血患者中有显著性差异,可鉴别诊断脑梗死与脑出血.%Objective To explore the difference and clinical significance between cerebral infarction and cerebral hemorrhage in patients with acute cerebral infarction.Methods 41 patients with acute cerebral infarction (cerebral infarction group) and 33 patients with acute cerebral hemorrhage (cerebral hemorrhage group) were selected.All patients were detected for plasma TG,TC,LDL,LP (a),G1U,CRP,UA,RBP and HCY,and compared whether they had significant difference,and to draw the ROC curve to the above related biochemical index level,and to judge the diagnostic value of cerebral infarction and cerebral hemorrhage.Results The level of TG,LDL,UA and RBP in cerebral infarction group was significantly higher than that in cerebral hemorrhage group,and the difference was statistically significant (t=2.0～ 4.36,all P＜0.05).The level of GLU and CRP in the cerebral infarction group was significantly lower than that in the cerebral hemorrhage group,and the difference was statistically significant (t=2.99,2.87,all P＜0.05).There was no significant difference in plasma TC,LP(a) and HCY levels between cerebral infarction group and cerebral hemorrhage group (t =0.95～1.85,all P＞0.05).The area under the ROC curve of subjects with TG,LDL,UA,GLU,CRP and RBP level AUC was 0.648,0.652,0.783,0.728,0.749 and 0.649 respectively and there was statistical significance in the judgment of cerebral infarction (all P＜0.05).The area under the ROC curve of plasma UA,GLU and CRP in patients with intracerebral hemorrhage AUC was 0.706,0.804 and 0.837 respectively,and there was statistical significance in the judgment of cerebral hemorrhage.Conclusion There were signifi cant differences between cerebral infarction and cerebral hemorrhage in related biochemical indexes,which could be used to differentiate cerebral infarction from cerebral hemorrhage.