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目的探讨生化标志物缺血修饰白蛋白(IMA)、脂蛋白a[Lp(a)]、纤维蛋白原(Fib)及D-二聚体(DD)的联合检测对急性缺血性脑卒中(acute ischemic stroke,AIS)的诊断价值。方法检测59例急性缺血性脑卒中患者及30例正常对照者血清中IMA、Lp(a)和血浆中Fib、DD浓度,计算其阳性率进行比较分析。结果缺血性脑卒中患者IMA、Lp(a)、Fib、DD阳性率分别为64.4%(38/59)、42.4%(25/59)、49.2(29/59)%、40.7%(24/59),与正常对照(0%、0%、3.3%、0%)比较,均有统计学意义(P<0.01),IMA敏感性与其他3项相比差异均有统计学意义(P<0.01),该4项指标联合检测的敏感性为92.3%(55/59),均高于单项检测,差异有统计学意义(P<0.01)。结论在急性缺血性脑卒中的早期,IMA是一个比较灵敏的指标,IMA、Lp(a)、Fib、DD4项指标联合检测诊断急性缺血性脑卒中可明显提高敏感性,有较高的临床实用价值。
Objective To investigate the clinical value of combined detection of biochemical markers IMA, Lp (a), fibrinogen (Fib) and D-dimer (DD) in patients with acute ischemic stroke acute ischemic stroke, AIS). Methods Serum levels of IMA, Lp (a) and Fib, DD in 59 patients with acute ischemic stroke and 30 normal controls were measured and their positive rates were calculated and compared. Results The positive rates of IMA, Lp (a), Fib and DD were 64.4% (38/59), 42.4% (25/59), 49.2 (29/59)%, 40.7% (P <0.01). The difference of IMA sensitivity between the two groups was statistically significant (P < 0.01). The sensitivities of these four indexes were 92.3% (55/59), which were higher than those of single test, the difference was statistically significant (P <0.01). Conclusion In the early stage of acute ischemic stroke, IMA is a sensitive index. The combined detection of IMA, Lp (a), Fib and DD4 can significantly improve the sensitivity of acute ischemic stroke, and the higher Clinical practical value.