【摘要】 目的探讨缺血性脑血管病(ICD)患者妊娠相关蛋白A(PAPP-A)水平的变化,及其在缺血性脑血管病中的诊断价值。方法将136例ICD患者分为急性脑梗死(ACI)组72例,短暂性脑缺血发作(TIA)组64例,另入选50例健康人作为对照组。72例ACI患者依据神经功能缺损程度分为轻型脑梗死组、中型脑梗死组和重型脑梗死组,采用ELISA方法检测血清PAPP-A的水平,并进行统计学分析。运用ROC曲线及曲线下面积(AUC)分析评价对急性缺血性脑血管病的诊断价值。结果 ACI组和TIA组血清PAPP-A水平均显著高于对照组(P<0.01),TIA组高于ACI组(P>0.05)。神经功能缺损越严重血清PAPP-A的水平越高,轻、中度脑梗死组与重度脑梗死组比较,组间比较差异均有统计学意义(P<0.01)。结论缺血性脑血管病患者血清PAPP-A的水平明显升高,其与神经功能缺损程度相关,测定血清PAPP-A的浓度可用于判断病情的严重程度,并对缺血性脑血管病具有临床诊断价值。更多还原

【Abstract】 Objective To investigate the change of pregnancy- associated plasma protein A( PAPP- A) in patients with ischemic cerebrovascular disease( ICD) and discuss its diagnostic value. Methods One hundred and thirty- six ICD patients,including 72 acute cerebral infarction patients( ACI group) and 64 transient ischemic attack patients( TIA group),and 50 healthy persons served as control group were involved in this study. In addition,72 ACI cases were subdivided into mild cerebral infarction group,moderate cerebral infarction group and severe cerebral infarction group. The levels of PAPP- A were determined in above the mentioned cases by enzyme- linked immunosorbent assay,and the results were analyzed by statistics. The diagnosis value of PAPP- A for ICD was analyzed and evaluated with the receiver operating characteristic( ROC) curve and the area under curve( AUC). Results The serum PAPP- A levels in ACI group and TIA group were significantly higher than the control group( P <0.01). The PAPP-A level in ACI group was higher than that in TIA group,but the difference had no statistical significance( P > 0. 05). Serum PAPP- A level showed positive correlation with the severity of neurologic impairment,and the difference of PAPP- A level showed statistical significance between severe cerebral infarction group and moderate cerebral infarction group,as well as mild cerebral infarction group( P < 0. 01). Conclusion The serum PAPP- A levels significantly increased in ICD patients,and correlated with the severity of neurological impairment. Serum PAPP- A level can be used to assess the severity of the disease,and it has certain clinical diagnostic value in ICD patients.更多还原