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利用ROC曲线评估急性脑梗死患者血管性血友病因子抗原(vWF:Ag)、D-二聚体(D-D)和纤维蛋白降解产物(FDP)的诊断价值。

Evaluating the diagnostic value of vWF:Ag, D-D and FDP in patients with acute cerebral infarction using ROC curves.

作者信息

Shi Dongmin, Xia Ting, Feng Hongxuan, Cheng Qingzhang

机构信息

Department of Laboratory Medicine, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu 215002, P.R. China.

First Cadres Sanatorium, Second Military Medical University, Shanghai 200433, P.R. China.

出版信息

Exp Ther Med. 2014 Jun;7(6):1573-1577. doi: 10.3892/etm.2014.1665. Epub 2014 Apr 3.

Abstract

Cerebral infarction is usually associated with arteriosclerosis, vascular endothelial cell injury and blood flow through the vascular system. The diagnostic value of markers, including von Willebrand factor antigen (vWF:Ag), D-dimer (D-D) and fibrinogen/fibrin degradation product (FDP), have not been studied in patients with acute cerebral infarction. Thus, the aim of the present study was to use receiver operating characteristic (ROC) curves to evaluate the diagnostic significance of vWF:Ag, D-D and FDP in 94 cases of acute cerebral infarction. The results revealed that vWF:Ag and D-D concentrations were significantly higher in acute cerebral infarction patients as compared with the normal controls (P<0.01), whereas no statistically significant difference in FDP was observed between the groups (P>0.01). Plasma vWF:Ag and D-D concentrations significantly correlated with the National Institute of Health Stroke Scale (NIHSS) scores (r=0.625 and 0.582, respectively; P<0.01). In addition, the vWF:Ag concentration significantly correlated with the D-D concentration (r=0.320; P<0.01), whereas FDP concentration did not correlate with D-D or vWF:Ag concentrations or the NIHSS scores (r=0.172, 0.188 and 0.065, respectively; P>0.05). The area under the ROC curve using vWF:Ag as a diagnostic marker in patients with acute cerebral infarction was 0.900, while for D-D the area was 0.795 and for FDP the area was 0.465. Logistic regression analysis revealed that the odds ratios of vWF:Ag and D-D were 16.727 and 2.324, respectively, which were statistically significant (P<0.001 and 0.023, respectively). These results indicated that using vWF:Ag as a diagnostic marker is likely to significantly improve the sensitivity of diagnosing patients with acute cerebral infarction. The diagnostic value of vWF:Ag concentration was significantly higher compared with D-D and FDP levels.

摘要

脑梗死通常与动脉硬化、血管内皮细胞损伤以及血管系统中的血流有关。包括血管性血友病因子抗原(vWF:Ag)、D-二聚体(D-D)和纤维蛋白原/纤维蛋白降解产物(FDP)在内的标志物在急性脑梗死患者中的诊断价值尚未得到研究。因此,本研究的目的是使用受试者工作特征(ROC)曲线来评估vWF:Ag、D-D和FDP在94例急性脑梗死患者中的诊断意义。结果显示,与正常对照组相比,急性脑梗死患者的vWF:Ag和D-D浓度显著更高(P<0.01),而两组之间FDP未观察到统计学显著差异(P>0.01)。血浆vWF:Ag和D-D浓度与美国国立卫生研究院卒中量表(NIHSS)评分显著相关(分别为r=0.625和0.582;P<0.01)。此外,vWF:Ag浓度与D-D浓度显著相关(r=0.320;P<0.01),而FDP浓度与D-D或vWF:Ag浓度以及NIHSS评分均无相关性(分别为r=0.172、0.188和0.065;P>0.05)。以vWF:Ag作为诊断标志物时,急性脑梗死患者ROC曲线下面积为0.900,D-D为0.795,FDP为0.465。逻辑回归分析显示,vWF:Ag和D-D的比值比分别为16.727和2.324,具有统计学显著性(分别为P<0.001和0.023)。这些结果表明,使用vWF:Ag作为诊断标志物可能会显著提高急性脑梗死患者诊断的敏感性。vWF:Ag浓度的诊断价值显著高于D-D和FDP水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bd2/4043620/5e41791ecd7a/ETM-07-06-1573-g00.jpg

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