CAJ | 학술논문

目的：探讨血浆生物标志物检查诊断急性脑梗死患者的特异性和敏感度，以辅助临床诊断和病情随访。方法分别测定150例急性脑梗死患者（观察组）和50例健康查体者（对照组）的血浆同型半胱氨酸（ Hcy）、内皮型一氧化氮合酶（eNOS）、可溶性血栓调节蛋白（sTM）、超敏C反应蛋白（hs－CRP）及血管性假血友病因子（vWF）水平。结果观察组血浆Hcy、eNOS、sTM、hs－CRP、vWF水平均显著高于对照组（ P均＜0．05）。根据ROC曲线得出当Hcy临界值为9．11μmol／L时诊断急性脑梗死的敏感性为95．2％、特异性为76％，eNOS临界值为437．30μmol／L时诊断的敏感性为79％、特异性为96％，sTM临界值为7．43μmol／L时诊断的敏感性为75．2％、特异性为96％，hs－CRP临界值为3．38 mg／L时诊断的敏感性为81．9％、特异性为90％，vWF临界值为194．85 ng／mL时诊断的敏感性为75．2％、特异性为80％。结论血浆Hcy、eNOS、sTM、hs－CRP、vWF水平可作为急性脑梗死诊断的辅助指标。
목적：탐토혈장생물표지물검사진단급성뇌경사환자적특이성화민감도，이보조림상진단화병정수방。방법분별측정150례급성뇌경사환자（관찰조）화50례건강사체자（대조조）적혈장동형반광안산（ Hcy）、내피형일양화담합매（eNOS）、가용성혈전조절단백（sTM）、초민C반응단백（hs－CRP）급혈관성가혈우병인자（vWF）수평。결과관찰조혈장Hcy、eNOS、sTM、hs－CRP、vWF수평균현저고우대조조（ P균＜0．05）。근거ROC곡선득출당Hcy림계치위9．11μmol／L시진단급성뇌경사적민감성위95．2％、특이성위76％，eNOS림계치위437．30μmol／L시진단적민감성위79％、특이성위96％，sTM림계치위7．43μmol／L시진단적민감성위75．2％、특이성위96％，hs－CRP림계치위3．38 mg／L시진단적민감성위81．9％、특이성위90％，vWF림계치위194．85 ng／mL시진단적민감성위75．2％、특이성위80％。결론혈장Hcy、eNOS、sTM、hs－CRP、vWF수평가작위급성뇌경사진단적보조지표。
Objective To explore the specificity and sensitivity of plasma biomarkers in patients with acute cerebral in-farction for clinical auxiliary diagnosis and a follow-up.Methods A total of 150 cases of acute cerebral infarction patients (ob-served group), 50 cases of healthy controls (control group) were included.Circular enzymatic and ELISA method and immune turbidimetric method were respectively used o determine the plasma homocysteine (Hcy), endothelial nitric oxide synthase (eNOS), soluble thrombus regulatory proteins (sTM), hypersensitive c-reactive protein (hs-CRP) and von willebrand factor (vWF) level.Results The plasma levels of those biomarkers as Hcy, eNOS.sTM, hs-CRP and vWF were significantly higher in observed group than those in healthy control group(P<0.05).Aarea under the ROC curve were respectively 0.938, 0.873, 0.879, 0.922 and 0.786.According to the ROC curve, when the Hcy critical value was 9.11μmol/L, the diagnostic sensitivity was 95.2%, the specificity was 76%.When the eNOS critical value was 437.30 μmol/L, the diagnostic sensitivity was 79%, the specificity was 96%.When the sTM critical value was 7.43 μmol/L, the diagnostic sensitivity was 75.2%, the specificity was 96%.When the hs-CRP threshold was 3.38 mg/L, the diagnostic sensitivity was 81.9%, the specificity was 90%;when the vWF critical value was 194.85 ng/mL, the diagnostic sensitivity was 75.2%, the specificity was 80%.Conclusion The levels of Hcy, eNOS, sTM, hs-CRP and vWF in plasma may be auxiliary biomarkers for the diagnosis of acute cerebral infarction .