血清NLR、UCH-L1联合ABCD2对孤立性眩晕患者脑梗死的诊断价值
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(保定市第一中心医院神经内科,河北省保定市 071000)

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张红霞,硕士,主治医师, 研究方向为脑血管病。通信作者张学艳,硕士,副主任医师,研究方向为脑血管病。

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保定市科技计划项目(18ZF087)


The value of serum NLR, UCH-L1 and ABCD2 in the diagnosis of cerebral infarction in patients with isolated vertigo
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Department of Neurology, the First Central Hospital of Baoding, Baoding, Hebei 071000, China)

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    目的 探讨血清中性粒细胞/淋巴细胞比值(NLR)、泛素羧基末端水解酶1(UCH-L1)联合ABCD2评分对孤立性眩晕患者脑梗死的诊断价值。方法 选择孤立性眩晕患者258例为研究对象,收集患者的临床资料,进行ABCD2评分,检测血清UCH-L1、NLR和影像学检查,根据结果分为合并脑梗死组(130例)和无脑梗死组(128例)。以发生脑梗死为因变量,ABCD2、UCH-L1、NLR为自变量建立Logistic回归模型,并通过绘制ROC曲线评估联合模型诊断价值。结果 合并脑梗死组与无脑梗死组ABCD2、UCH-L1、NLR差异有统计学意义(P<0.05)。发生脑梗死为因变量,ABCD2、UCH-L1、NLR为自变量建立Logistic回归模型,结果显示孤立性眩晕患者脑梗死的危险因素包括ABCD2(OR=1.861,95%CI:1.118~3.098)、UCH-L1(OR=1.257,95%CI:1.012~1.563)、NLR(OR=1.075,95%CI:1.005~1.149)。以发生脑梗死为因变量,以ABCD2、UCH-L1、NLR为自变量, 通过模型中的概率值来拟合联合诊断的ROC曲线,结果显示ABCD2、UCH-L1、NLR诊断眩晕患者脑梗死的临界值为3分、0.19 μg/L、2.01,ROC曲线下面积为0.706(0.642~0.771)、0.603(0.533~0.672)、0.633(0.566~0.700),灵敏度为0.632、0.511、0.603,特异度为0.814、0.921、0.621,联合预测曲线下面积为0.744(0.681~0.807),灵敏度为0.861,特异度为0.602,灵敏度优于单独诊断。结论 血清NLR、UCH-L1联合ABCD2对孤立性眩晕患者合并脑梗死判断具有潜在临床评估价值。

    Abstract:

    Aim To explore the value of serum NLR, UCH-L1 and ABCD2 in the diagnosis of cerebral infarction in patients with isolated vertigo. Methods 258 patients with isolated vertigo were enrolled. According to the results, the patients were divided into 130 patients with cerebral infarction and 128 patients without cerebral infarction. The clinical data of the patients, ABCD2 scores, serum UCH-L1, NLR and imaging examinations were evaluated and compared between two groups. Logistic regression model was employed to produce new variables for diagnosis of cerebral infarction and assessed with ROC curve. Results ABCD2, UCH-L1 and NLR in cerebral infarction group were significantly higher than those in non-cerebral infarction group (P<0.05). Taking cerebral infarction as the dependent variable and ABCD2, UCH-L1, NLR as the independent variables, Logistic regression model was established, and ROC curve of combined diagnosis was fitted by the probability value in the model. ABCD2 (OR=1.1,5%CI:1.118~3.098), UCH-L1 (OR=1.7,5%CI:1.012~1.563) and NLR (OR=1.5,5%CI:1.005~1.149) were the risk factors of cerebral infarction in patients with isolated vertigo. ROC results showed that the critical value of ABCD2, UCH-L1 and NLR in the diagnosis of cerebral infarction was 3 points, 0.19 μg/L, 2.01, the area under ROC curve was 0.706 (0.642~0.771), 0.603 (0.533~0.672), 0.633 (0.566~0.700), the sensitivity was 0.2,0.1,0.603, and the specificity was 0.4,0.1,0.621. While the Logistic combination prediction module showed the AUC was 0.744 (0.681~0.807), the sensitivity was 0.861 and the specificity was 0.602. The sensitivity was higher than that of single diagnosis. Conclusion UCH-L1 and NLR combined with ABCD2 presents potential clinical evaluation value in the diagnosis of cerebral infarction in patients with isolated vertigo.

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张红霞,刘福兴,张丽,张学艳,周瑾.血清NLR、UCH-L1联合ABCD2对孤立性眩晕患者脑梗死的诊断价值[J].中国动脉硬化杂志,2020,28(2):154~157.

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  • 收稿日期:2019-05-15
  • 最后修改日期:2019-08-06
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  • 在线发布日期: 2020-01-20