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目的:探讨血清细胞角质蛋白片段18 （CCCK-18）在缺血性脑卒中（CIS）患者的变化及诊断价值。方法:选取2018年10月至2019年10月湖北医药学院附属东风医院诊治的106例CIS患者作为研究组，同期行数字减影全脑血管造影（DSA）检查显示颅内外无显著异常的其他颅脑疾病患者90例作为对照组，两组基线资料比较差异无统计学意义（n P>0.05）。采集两组研究对象肘静脉血5 ml，采用酶联免疫吸附法检测血清CCCK-18水平；酶法检测总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）。利用受试者工作特征（ROC）曲线分析血清CCCK-18对CIS患者的诊断效能，Pearson检验分析血清CCCK-18水平与TC、TG、LDL-C、HDL-C的相关性。n 结果:研究组血清CCCK-18、TC、TG、LDL-C水平明显高于对照组[（158.10 ± 50.89） U/L比（85.57 ± 35.25） U/L、（4.26 ± 0.92） mmol/L比（3.92 ± 0.80） mmol/L、 （2.34 ± 0.53） mmol/L比（1.83 ± 0.47） mmol/L、（3.12 ± 0.73） mmol/L比（2.61 ± 0.67） mmol/L]， HDL-C低于对照组[（1.20 ± 0.24） mmol/L比（1.32 ± 0.28） mmol/L]，差异有统计学意义（n P<0.05）。Logistic回归分析结果显示，CCCK-18、TC、TG、LDL-C、HDL-C是CIS患者独立危险因素（n P<0.05）。血清CCCK-18鉴别CIS患者与对照组的曲线下面积（AUC）为0.878，灵敏度和特异度分别为84.91%、78.89%；鉴别轻度CIS患者AUC为0.763，灵敏度和特异度分别为70.37%、78.89%。相关性分析显示，CIS患者血清CCCK-18与TC、TG、LDL-C呈正相关（n r = 0.711、0.722、0.705），与HDL-C呈负相关（n r = - 0.714），差异均有统计学意义（n P0.05). Cubital venous blood of 5 ml from two groups of subjects were collected, and the level of serum CCCK-18 was detected by enzyme-linked immunosorbent assay. The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were detected by enzymatic method. The receiver operating characteristic curve (ROC curve) was used to analyze the diagnostic efficacy of serum CCCK-18 in patients with ischemic stroke, and the relationship between serum CCCK-18 and TC, TG, LDL-C, HDL-C were analyzed by Pearson test.n Results:The levels of serum CCCK-18, TC, TG, and LDL-C in the study group were significantly higher than those in the control group: (158.10 ± 50.89) U/L vs. (85.57 ± 35.25) U/L, (4.26 ± 0.92) mmol/L vs. (3.92 ± 0.80) mmol/L, (2.34 ± 0.53) mmol/L vs. (1.83 ± 0.47) mmol/L, (3.12 ± 0.73) mmol/L vs. (2.61 ± 0.67) mmol/L, and HDL-C level was lower than that in the control group: (1.20 ± 0.24) mmol/L vs. (1.32 ± 0.28) mmol/L, and there were significant differences (n P<0.05). Logistic regression analysis showed that CCCK-18, TC, TG, LDL-C, and HDL-C were independent risk factors for patients with ischemic stroke (n P<0.05). The area under the curve(AUC) of serum CCCK-18 to distinguish ischemic stroke from the control group was 0.878, with a sensitivity of 84.91% and a specificity of 78.89%. The AUC of serum CCCK-18 to identify patients with mild ischemic stroke was 0.763, with a sensitivity of 70.37% and a specificity of 78.89%. Correlation analysis showed that serum CCCK-18 was positively correlated with TC, TG, and LDL-C in patients with ischemic stroke (n r = 0.711, 0.722, 0.705), and negatively correlated with HDL-C (n r = - 0.714), and there were significant differences (n P<0.01).n Conclusions:Serum CCCK-18 levels are significantly increased in patients with cerebral ischemic stroke, which can be used as a biomarker for diagnosis and judgment of disease severity.