动脉粥样硬化性脑梗死患者血浆Hcy、hs-CRP、Cys-C及D-二聚体联合检测分析

摘要

Objective To investigate the changes and clinical significance of plasma Hcy (homocysteine), hs-CRP (hypersensitive C-reactive protein), Cys-C (cystatin C) and D-dimer in patients with atherosclerotic cerebral infarction.Methods Plasma Hcy, hs-CRP, Cys-C, D-dimer concentrations and neurological function scores were measured in 85 patients with atherosclerotic cerebral infarction (divided into plaque-free group and plaque-containing group, the latter divided into stable plaque group and unstable plaque group) and 80 healthy subjects.Results The concentration levels of Hcy, hs-CRP, Cys-C and D-dimer in atherosclerotic cerebral infarction group were higher than those in the control group, with plaque group higher than without plaque group, unstable plaque group higher than stable plaque group, the differences were statistically significant (P<0.05).The four concentration levels were positively correlated with the severity of cerebral infarction.The positive rate of four combined tests was much higher than that of single test.Conclusion Plasma Hcy, hs-CRP, Cys-C and D-dimer levels are related to the development and diagnosis of atherosclerotic cerebral infarction.The combined determination of four items has high clinical value for the diagnosis of atherosclerotic cerebral infarction.%目的 探讨动脉粥样硬化性脑梗死患者血浆同型半胱氨酸(Hcy) 、超敏C反应蛋白(hs-CRP) 、胱抑素C(Cys-C) 及D-二聚体联合检测的价值.方法 对85例动脉粥样硬化性脑梗死患者(分为无斑块组及有斑块组, 后者又分为稳定斑块组及不稳定斑块组) 及80例健康体检者进行血浆Hcy、hs-CRP、Cys-C、D-二聚体浓度测定及神经功能评分.结果 Hcy、hs-CRP、Cys-C及D-二聚体浓度在动脉粥样硬化性脑梗死组中均高于对照组, 有斑块组高于无斑块组, 不稳定斑块组高于稳定斑块组, 差异均有统计学意义(均P<0.05);4种指标浓度均与脑梗死严重程度呈正相关;4种指标联合测定的阳性率远高于单项测定的阳性率.结论 血浆Hcy、hs-CRP、Cys-C及D-二聚体水平与动脉粥样硬化性脑梗死病情发展及诊断相关, 4种指标联合测定对于动脉粥样硬化性脑梗死诊断具有较高的临床价值.