血浆D-二聚体和血清脂蛋白磷脂酶A2在脑小血管病患者中的诊断价值及其与疾病严重程度的关系。
Diagnostic value of plasma D-dimer and serum lipoprotein phospholipase A2 in patients with cerebral small vessel disease and their association with severity of the disease.
作者信息
Kong Yu, Lin Guangyao, Yan Mingguang, Wang Jingjing, Dai Yunyi
机构信息
Department of Cognitive and Movement Disorders, Shangqiu First People's Hospital 292 Kaixuan South Road, Suiyang District, Shangqiu 476000, Henan, China.
Medical Imaging Center, Shangqiu First People's Hospital 292 Kaixuan South Road, Suiyang District, Shangqiu 476000, Henan, China.
出版信息
Am J Transl Res. 2022 Nov 15;14(11):8371-8379. eCollection 2022.
OBJECTIVE
To determine the diagnostic value of plasma D-dimer (DD) and serum lipoprotein phospholipase A2 (Lp-PLA2) in patients with cerebral small vessel disease (CSVD) and their association with severity of the disease.
METHODS
In this retrospective analysis, 84 patients with CSVD treated in Shangqiu First People's Hospital from February 2020 to November 2021 were included in the study group, and 75 healthy individuals were assigned into the control group. The DD and Lp-PLA2 levels in the two groups were compared, and the diagnostic value of the two in CSVD was evaluated via receiver operating characteristic (ROC) curves. Patients were assigned to a mild group or a severe group based on Fazekas scale scores. Then, the two groups were compared in terms of the DD and Lp-PLA2 levels, and the association of the two with the severity of CSVD was determined through ROC curves. With the Montreal cognitive assessment (MoCA) scale, the patients were assigned to a cognitive impairment group or a non-cognitive impairment group. Then the two groups were compared in terms of the DD and Lp-PLA2 levels, and the association of the two with the cognitive function of CSVD patients was also determined by ROC curves.
RESULTS
The research group showed higher DD and Lp-PLA2 levels than the control group; the severe group showed higher DD and Lp-PLA2 levels than the mild group; the cognitive impairment group showed higher DD and Lp-PLA2 levels than the non-cognitive impairment group (all P < 0.001). The areas under the curves (AUCs) of DD and Lp-PLA2 in CSVD diagnosis were 0.902 and 0.907, respectively; the AUCs of DD and Lp-PLA2 in CSVD severity determination were 0.747 and 0.704, respectively; the AUCs of DD and Lp-PLA2 in cognitive impairment diagnosis were 0.736 and 0.725, respectively.
CONCLUSION
Plasma DD and Lp-PLA2 possess good diagnostic value in patients with CSVD, and also has certain clinical value in diagnosing patients' severity and cognitive impairment.
目的
探讨血浆D-二聚体（DD）和血清脂蛋白磷脂酶A2（Lp-PLA2）对脑小血管病（CSVD）患者的诊断价值及其与疾病严重程度的关系。
方法
本回顾性分析纳入2020年2月至2021年11月在商丘市第一人民医院接受治疗的84例CSVD患者作为研究组，另选取75例健康个体作为对照组。比较两组的DD和Lp-PLA2水平，并通过受试者工作特征（ROC）曲线评估二者对CSVD的诊断价值。根据 Fazekas量表评分将患者分为轻度组和重度组。然后，比较两组的DD和Lp-PLA2水平，并通过ROC曲线确定二者与CSVD严重程度的关系。采用蒙特利尔认知评估（MoCA）量表将患者分为认知障碍组和非认知障碍组。然后比较两组的DD和Lp-PLA2水平，并通过ROC曲线确定二者与CSVD患者认知功能的关系。
结果
研究组的DD和Lp-PLA2水平高于对照组；重度组的DD和Lp-PLA2水平高于轻度组；认知障碍组的DD和Lp-PLA2水平高于非认知障碍组（均P<0.001）。DD和Lp-PLA2诊断CSVD的曲线下面积（AUC）分别为0.902和0.907；DD和Lp-PLA2判断CSVD严重程度的AUC分别为0.747和0.704；DD和Lp-PLA2诊断认知障碍的AUC分别为0.736和0.725。
结论
血浆DD和Lp-PLA2对CSVD患者具有良好的诊断价值，对判断患者病情严重程度及认知障碍也具有一定的临床价值。
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