标题：短暂性脑缺血发作患者血液标志物的检测及其临床意义

      作者：徐东升，黄伟，陈炜，胡玲玲
    (南通大学附属第三医院，无锡市第三人民医院内科，江苏 无锡 214041)

      卷次： 2016年27卷8期

      【摘要】 目的 测定短暂性脑缺血发作(TIA)患者血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、尿酸
(UA)和血浆D-二聚体(DD)、纤维蛋白原(FIB)含量，并探讨其与TIA的内在联系。方法 选取 2012年 1月至 2015
年 4月我院收治的 76例短暂性脑缺血患者作为TIA组，随机选取同期在我院做健康体检的 70例健康者作为对照
组。获取两组受检者的空腹血液标本，立即用全自动生化分析仪日立 7600检测其血清Hcy、hs-CRP、UA的浓度，
SysmexCA8000全自动血凝仪测定血浆DD、FIB水平。比较不同组受检者的血清Hcy、hs-CRP、UA及血浆DD、FIB
含量和阳性检出率，并对TIA组患者血清Hcy、hs-CRP、UA和血浆DD、FIB之间进行直线相关性分析，以研究血液标志
物与TIA的内在联系。结果 与对照组比较，TIA组的血清Hcy [(14.67+5.16) μmol/L vs (8.91+3.01) μmol/L]、hs-CRP
[(2.20±1.72) mg/L vs (1.55±0.95) mg/L]、UA [(329.43±87.07) μmol/L vs (254.67±53.80) μmol/L]及血浆DD [(0.37±
0.20) mg/L vs (0.25±0.11) mg/L]、FIB [(2.80±0.52) g/L vs (2.20±0.46) g/L]含量有明显升高，差异均有统计学意义(P<
0.05)；TIA组患者的Hcy与hs-CRP、UA、DD、FIB无相关性(r=0.057、0.057、0.064、0.084，P>0.05)；TIA组患者的Hcy、
UA、DD阳性检出率分别为46.1%、17.1%和17.1%，均高于对照组的11.4%、4.3%和4.3%，差异均有统计学意义(P<
0.05)。结论 TIA患者的血清Hcy、hs-CRP、UA和血浆DD、FIB浓度水平均比正常人明显增高；五项血液标志物和
TIA的发生可能有密切联系。

      【关键词】 同型半胱氨酸；C反应蛋白；尿酸；D-二聚体；纤维蛋白原；短暂性脑缺血发作

      【中图分类号】 R734.31 【文献标识码】 A 【文章编号】 1003—6350（2016）08—1219—03


Detection of blood markers in patients with transient ischemic attack and its clinical significance.
XU Dong-sheng,
HUANG Wei, CHEN Wei, HU Ling-ling. Department of Internal Medicine, the Third People's Hospital of Wuxi (the Third
Affiliated Hospital of Nantong University), Wuxi 214041, Jiangsu, CHINA

【Abstract】 Objective To determine the levels of serum homocysteine (Hcy), uric acid (UA), ultra sensi-
tive C reactive protein (hs-CRP), plasma D dimer (DD) and fibrin original (FIB) in patients with transient ischemic
attack (TIA), and explore the intrinsic relationship between these five indexes and TIA. Methods During the peri-
od from January 2012 through April 2015, 76 cases of transient cerebral ischemia in our hospital were chosen as TIA
group. Meantime, 70 healthy people were randomly selected as the control group. Fasting blood samples of the two
groups were obtained. Concentrations of their serum Hcy, hs-CRP, UA were detected by HITACHI 7600 Fully Automat-
ic Biochemical Analyzer, and the levels of plasma D-dimer and FIB were measured by Sysmex CA8000 Fully Automatic
Coagulometer. The levels of Hcy, UA, hs-CRP, DD and FIB and positive detection rate were compared. In the TIA
group, the linear correlations between UA, hs-CRP, DD, FIB and Hcy were analyzed for determining the internal relation of
blood markers with TIA. Results Compared with the control group, The levels of serum Hcy [(14.67±5.16) μmol/L vs
(8.91+3.01) μmol/L], hs-CRP [(2.20±1.72) mg/L vs (1.55±0.95) mg/L], UA [(329.43±87.07) μmol/L vs (254.67±53.80) μmol/L],
DD [(0.37±0.20) mg/L vs (0.25±0.11) mg/L] and FIB [(2.80±0.52) g/L vs (2.20±0.46) g/L] in TIA group were significant-
ly increased, and the differences were statistically significant (P<0.05). in TIA Group, there was no significant correla-
tion between Hcy and hs-CRP, UA, plasma D-dimer, FIB (r=0.057, 0.057, 0.064, 0.084, P>0.05). The positive detection
rate of Hcy (46.1%), UA (17.1%) and DD (17.1%) in the TIA group were significantly higher than the positive detection
rate of Hcy (11.4%), UA (4.3%) and DD (4.3%) in the control group, and the differences were statistically significant (P<
0.05). Conclusion Compared with the healthy people, the levels of serum Hcy, hs-CRP, uric acid, plasma D-dimer and
FIB in patients with TIA were significantly increased. There are very close relationships between the five blood markers
and the occurrence of transient ischemic attack.

      【Key words】 Homocysteine; C-reactive protein; Uric acid; D-dimer; Fibrinogen; Transient ischemic attack (TIA)
·论 著·
6350.2016.08.004