CAJ | 학술논문

目的：探讨不同方法检测同型半胱氨酸（homocysteine ，Hcy）对高血压合并脑梗死的诊断价值。方法分别采用荧光定量法和循环酶法检测单纯高血压组、高血压合并脑梗死组及健康对照组 Hcy的水平，采用受试者工作特征（receiver operat‐ing characteristic ，ROC ）曲线分析评价2种方法检测 Hcy对高血压合并脑梗死的诊断效能。结果两种方法均显示单纯高血压组、高血压合并脑梗死组血清 Hcy水平、高Hcy发生率均显著高于对照组（P＜0．05），但单纯高血压组与高血压合并脑梗死组之间血清Hcy水平及高 Hcy发生率均无明显差异（P＞0．05）。ROC曲线分析循环酶法检测 Hcy的诊断灵敏度（67．5％）和特异性（85．3％）均较高，而荧光定量法灵敏度较低（40％），特异性好（97．1％）；H cy与三酰甘油联合诊断的灵敏度为72．5％，特异性为94．1％，均高于 Hcy单指标诊断效能。结论 Hcy的升高与高血压相关，但与高血压合并脑梗死并非有直接的因果关系。循环酶法检测Hcy对高血压合并脑梗死的诊断效能优于荧光定量法，Hcy与三酰甘油联合检测有助于提高对高血压合并脑梗死诊断灵敏度和特异性。
목적：탐토불동방법검측동형반광안산（homocysteine ，Hcy）대고혈압합병뇌경사적진단개치。방법분별채용형광정량법화순배매법검측단순고혈압조、고혈압합병뇌경사조급건강대조조 Hcy적수평，채용수시자공작특정（receiver operat‐ing characteristic ，ROC ）곡선분석평개2충방법검측 Hcy대고혈압합병뇌경사적진단효능。결과량충방법균현시단순고혈압조、고혈압합병뇌경사조혈청 Hcy수평、고Hcy발생솔균현저고우대조조（P＜0．05），단단순고혈압조여고혈압합병뇌경사조지간혈청Hcy수평급고 Hcy발생솔균무명현차이（P＞0．05）。ROC곡선분석순배매법검측 Hcy적진단령민도（67．5％）화특이성（85．3％）균교고，이형광정량법령민도교저（40％），특이성호（97．1％）；H cy여삼선감유연합진단적령민도위72．5％，특이성위94．1％，균고우 Hcy단지표진단효능。결론 Hcy적승고여고혈압상관，단여고혈압합병뇌경사병비유직접적인과관계。순배매법검측Hcy대고혈압합병뇌경사적진단효능우우형광정량법，Hcy여삼선감유연합검측유조우제고대고혈압합병뇌경사진단령민도화특이성。
Objective To evaluate the value of homocysteine(Hcy) detection by different assays in the diagnosis of hypertension complicating cerebral infarction disease .Methods Serum concentration of Hcy in the patients with single hypertension ,hyperten‐sion complicating cerebral infarction and healthy controls were detected by the fluorescence quantification assay and the enzymatic cycling assay respectively ,the application value of the two assays in the diagnosis of hypertension complicating cerebral infarction disease was evaluated by the receiver operating characteristic (ROC) curve .Results Both the two assays showed that the serum Hcy level and incidence of high Hcy in the single hypertension group and the hypertension complicating cerebral infarction group were obviously higher than those in the healthy control group (P<0 .05) ,but there were no statistically significant differences be‐tween the single hypertension group and the hypertension complicating cerebral infarction group (P>0 .05) .The ROC curve analy‐sis showed that the sensitivity and the specificity in the enzymatic cycling assay were higher ,which were 67 .5% and 85 .3% respec‐tively ,but the fluorescence quantification assay had lower sensitivity (40 .0% ) and higher specificity (97 .1% ) .Compared to the sin‐gle index test ,the sensitivity of Hcy and triglyceride combination detection had higher sensitivity (72 .5% ) and higher specificity (94 .1% ) ,which were higher than the diagnostic performance of the single index .Conclusion The increase of serum Hcy level is closely related to hypertension ,but is not a direct causal relationship with hypertension complicating cerebral infarction .The enzy‐matic cycling assay is better than the fluorescence quantitative assay in the diagnostic performance of hypertension complicating cer‐ebral infarction .The combination detection of Hcy and triglyceride conduces to improve the diagnostic sensitivity and specificity .