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目的研究和肽素(CPP)及血管内皮生长因子(VEGF)水平在急性脑梗死患者诊断、病情预测及相关性。方法选取2013年9月至2016年9月间于佳木斯大学附属第一医院确诊并接受治疗的急性脑梗死患者共98例为研究组,另选取同一时期在本院接受头颅磁共振检查,结果显示一切正常者98例为对照组。用ELISA法检测两组患者的CPP和VEGF水平;用NIHSS法来评价两组患者的神经系统功能;通过对患者进行MRI检查来划分病灶;用CDU检测患者的颈动脉硬化程度,根据IMT判断标准分为正常组、增厚组和斑块形成组,分别对各指标进行分析。结果研究组与对照组比较,在平均血小板体积(MPV)、纤维蛋白原(Fg)、血尿酸(UA)指标上差异无统计学意义(P>0.05),在TG、HDL-C、FPG、HCY、PCT、RDW、HTC等指标上差异均有统计学意义(P<0.05)。CPP和VEGF的AUC值比Hs-CRP大,在灵敏度方面Hs-CRP值最小,特异度方面CPP值最大;CPP和VEGF水平在不同神经障碍组和不同病灶组的比较,严重组到轻微组,大病灶组到小病灶组均呈下降趋势;颈动脉粥样斑块组的CPP和VEGF水平比IMT正常组高,IMT增厚组比IMT正常组高,差异均有统计学意义(P<0.05),颈动脉粥样斑块组的CPP和VEGF水平与IMT增厚组比较差异无统计学意义(P>0.05)。结论 CPP和VEGF水平可以用来预测脑梗死的发生,且灵敏度较高;可以用来检测脑梗死患者神经功能的缺损程度;可以用来检测颈动脉病变的发生率;为急性脑梗死的诊断和预后提供重要依据。
Objective To investigate the diagnosis, prognosis and correlation of copeptin (CPP) and vascular endothelial growth factor (VEGF) levels in patients with acute cerebral infarction. Methods A total of 98 patients with acute cerebral infarction who were diagnosed and treated at the First Affiliated Hospital of Jiamusi University from September 2013 to September 2016 were selected as the study group. The subjects were selected to receive head magnetic resonance imaging in our hospital from September 2013 to September 2016, 98 cases of normal control group. The levels of CPP and VEGF in both groups were measured by ELISA. The NIHSS was used to evaluate the neurological function in both groups. The lesions were divided by MRI examination. The extent of carotid atherosclerosis was detected by CDU. According to the criteria of IMT Divided into normal group, thickening group and plaque formation group, respectively, the indicators were analyzed. Results There were no significant differences in mean platelet volume (MPV), fibrinogen (Fg) and serum uric acid (UA) between study group and control group (P> 0.05) HCY, PCT, RDW, HTC and other indicators were significantly different (P <0.05). The AUC value of CPP and VEGF was greater than that of Hs-CRP, the smallest Hs-CRP value in sensitivity and the largest CPP value in specificity. The levels of CPP and VEGF in different neurological disorders group and different lesions group were significantly lower than those in mild group, The levels of CPP and VEGF in the carotid atherosclerotic plaque group were higher than those in the normal IMT group and IMT thicker group than those in the normal IMT group (P <0.05) ). The levels of CPP and VEGF in carotid atherosclerotic plaque group were not significantly different from IMT thickening group (P> 0.05). Conclusions The levels of CPP and VEGF can be used to predict the occurrence of cerebral infarction with high sensitivity. It can be used to detect the degree of neurological deficits in patients with cerebral infarction. It can be used to detect the incidence of carotid artery disease. For the diagnosis of acute cerebral infarction Prognosis provides an important basis.