目的探讨脂蛋白相关磷酯酶(Lp-PL)A2对急性脑血栓形成(CT)的诊断价值。方法选取通过病史、症状和体查拟诊为疑似脑CT患者115例,再采用诊断金标准分为脑CT(65例)和非脑CT组(50例),所有研究对象均采用,ELISA法测定Lp-PLA2,采用循证检验医学的方法统计各诊断价值性能指标。结果脑CT组Lp-PLA2为(250.6±145.6)ng/ml,较非脑CT组〔(152.9±59.0)ng/ml〕浓度非常显著升高(P<0.001)。Lp-PLA2对脑CT具有最高诊断效率的诊断界值为173.5 ng/ml,在该界值的诊断灵敏度为67.7%,特异性为84.0%,阳性预测值84.6%,阴性预测值66.7%,阳性似然比4.23,阴性似然比0.38,诊断效率74.8%。根据拟诊率50.5%,计算获得Lp-PLA2对脑CT的诊断概率81.2%,误诊概率18.8%,漏诊概率27.8%,排除概率72.2%。结论单一指标Lp-PLA2对急性脑CT的诊断价值为中等。 Objective To investigate the diagnostic value of lipoprotein-associated phosphatase (Lp-PL) A2 in acute cerebral thrombosis (CT). Methods One hundred and fifteen patients diagnosed as suspected brain CT by medical history, symptom and physical examination were selected and divided into brain CT (65 cases) and non-brain CT group (50 cases) according to the gold standard of diagnosis. All subjects were studied by ELISA Determination of Lp-PLA2, using evidence-based test methods of medical diagnostic performance statistics. Results The level of Lp-PLA2 in brain CT group was (250.6 ± 145.6) ng / ml, which was significantly higher than that in non-brain CT group (152.9 ± 59.0 ng / ml) (P <0.001). The diagnostic limit of Lp-PLA2 for the highest diagnostic efficiency of brain CT was 173.5 ng / ml. The diagnostic sensitivity of Lp-PLA2 was 67.7%, the specificity was 84.0%, the positive predictive value was 84.6% and the negative predictive value was 66.7% Likelihood Ratio 4.23, Negative Likelihood Ratio 0.38, Diagnostic Efficiency 74.8%. According to the 50.5% probability of diagnosis, the diagnostic probability of Lp-PLA2 was 81.2%, the misdiagnosis probability was 18.8%, the misdiagnosis probability was 27.8% and the exclusion probability was 72.2%. Conclusion The single marker Lp-PLA2 has a moderate diagnostic value for acute brain CT.