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目的研究高敏C反应蛋白(hs-CRP)和纤维蛋白原(Fib)水平与急性脑血管病(ACVD)的相关性,为ACVD的诊治提供临床依据。方法 63例同期我院住院的ACVD病人,其中脑出血(ICH)组21例,急性脑梗死(ACI)组42例;同期入院非脑血管病患者36例,我院门诊健康体检者41例作为正常对照组,共计总数140例。免疫比浊增强法测定hs-CRP水平,凝固法测定Fib水平,对各组hs-CRP与Fib均数进行比较,并行相关性分析和绘制ROC曲线,研究hs-CRP、Fib与ACVD的关系及临床应用价值。结果①各组血清hs-CRP含量比较,ACI组hs-CRP含量明显增高(7.72±3.32),与正常对照组(2.17±1.33)、ICH组(2.45±1.31)及非脑血管病组(2.73±2.43)相比均有显著差异(p<0.01);ICH组与ACI组及正常对照组比较有差异(p<0.05),但较非脑血管病组相比差异无显著性(p>0.05);②各组血清Fib含量比较ICH组Fib含量增高明显(3.68±0.84),较正常对照组(2.55±0.56)、AACI组(3.27±0.85)及非脑血管病组(2.98±0.57)相比差异均有统计学意义(p<0.05),ACI组与ICH组、正常对照组相比差异有显著性(p<0.05),与非脑血管病组比较无差异(p>0.05);③各组hs-CRP与Fib相关性AACI组hs-CRP与Fib含量正相关(γ=0.376,P=0.014),ICH组hs-CRP与Fib含量不相关(γ=0.155,P=0.502),非脑血管病组hs-CRP与Fib含量正相关(γ=0.446,P=0.006),正常对照组hs-CRP与Fib含量正相关(γ=0.574,P=0.000);④hs-CRP、Fib ROC曲线分析hs-CRP、Fib ROC曲线下面积分别为0.789、0.729,面积的95%可信区间分别为0.705,0.873、0.645,0.813,两指标诊断ACVD有显著意义(P=0.000,P=0.000),含量越高诊断ACVD的可能性越大,hs-CRP对ACVD的敏感性较Fib高。结论 hs-CRP及Fib均参与了动脉粥样硬化、ACVD的病理生理过程,是评价机体损伤的总体量化指标,在ACVD的辅助诊断中具有一定的运用价值,其中hs-CRP对ACVD的诊断价值优于Fib,两者之间动态平衡破坏间接提示机体损伤严重程度,因此检测两者之间的动态变化能为临床早期判断预后及指导治疗提供依据。
Objective To investigate the correlation between the levels of hs-CRP and fibrinogen (Fib) and acute cerebrovascular disease (ACVD) and provide the clinical evidence for the diagnosis and treatment of ACVD. Methods Sixty-three patients with ACVD who were admitted to our hospital during the same period were enrolled in this study. Among them, 21 were ICH and 42 were ACI; 36 were hospitalized with non-cerebrovascular disease during the same period; The normal control group, a total of 140 cases. The levels of hs-CRP were measured by immuno turbidimetric assay. The levels of Fib were measured by coagulation method. The mean hs-CRP and Fib were compared between groups. The correlation between hs-CRP and Fib was analyzed. Clinical application value. Results ① Compared with the control group (2.17 ± 1.33), the ICH group (2.45 ± 1.31) and the non-cerebrovascular disease group (2.73 ± 1.31), the hs-CRP level in the ACI group was significantly higher (7.72 ± 3.32) ± 2.43) (p <0.01). There was significant difference between ICH group and ACI group and normal control group (p <0.05), but no significant difference compared with non-cerebrovascular disease group (p> 0.05) (2) Compared with normal control group (2.55 ± 0.56), AACI group (3.27 ± 0.85) and non-cerebrovascular disease group (2.98 ± 0.57), the Fib content in each group increased significantly (3.68 ± 0.84) (P <0.05). There was significant difference between ACI group and ICH group and normal control group (p <0.05), but no difference with non-cerebrovascular disease group (p> 0.05); There was a positive correlation between hs-CRP and Fib content in each group (r = 0.376, P = 0.014). There was no correlation between hs-CRP and Fib content in ICH group (r = 0.155, P = 0.502) There was a positive correlation between hs-CRP and Fib content in cerebrovascular disease group (γ = 0.446, P = 0.006), hs-CRP and Fib content in normal control group (γ = 0.574, Analysis hs-CRP, Fib ROC area under the curve were 0.789,0.729, 95% confidence interval area were 0.705,0.873,0.645,0.813, two indicators of the diagnosis of ACVD was significant (P = 0.000, P = 0.000), the higher the diagnosis of the possibility of ACVD the greater the sensitivity of hs-CRP ACVD higher than Fib. Conclusion Both hs-CRP and Fib are involved in the pathophysiological process of atherosclerosis and ACVD, which are the overall quantitative indexes to evaluate the injury of the body. They have some value in the auxiliary diagnosis of ACVD. The diagnostic value of hs-CRP to ACVD Which is better than Fib. The dynamic equilibrium between them destroys the severity of indirect injury promptly, so detecting the dynamic changes between the two can provide the basis for early prognosis and guiding treatment.