血清CTRP3、CTRP9 在急性脑梗死患者中的 表达及诊断价值研究

Clinical value of serum CTRP3 and CTRP9 in diagnosis of acute ischemic stroke

摘要:

目的 研究血清CTRP3、CTRP9 在急性脑梗死（ACI）患者中的表达及对ACI 的诊断价值。 方法 选取2017 年6 月—2018 年6 月在延安大学附属医院就诊的85 例ACI 患者作为观察组，另选该院同 期健康体检者80 例作为对照组。比较两组血清CTRP3、CTRP9 水平并分析其诊断价值，Logistic 回归模型 拟合联合诊断，通过受试者工作特征曲线，分析两者联合诊断潜力。结果 观察组血清CTRP3、CTRP9 水 平低于对照组（P <0.05）。以CTRP3 ≤ 295.22 ng/ml 为截断值，其对ACI 诊断的敏感性为76.47%（95% CI ：0.658，0.847），特异性为78.75%（95% CI ：0.679，0.868），AUC 为0.803（95% CI ：0.751，0.854）。以 CTRP9 ≤ 282.15 ng/ml 为截断值，其对ACI 诊断的敏感性为74.12%（95% CI ：0.633，0.827），特异性为 88.75%（95% CI ：0.792，0.944），AUC 为0.763（95% CI ：0.710，0.816）。联合诊断模型诊断ACI 的敏感性为 81.18%（95% CI ：0.709，0.885），特异性为76.25%（95% CI ：0.652，0.847），AUC 为0.870（95% CI ：0.832， 0.908）；同时联合诊断模型AUC 高于CTPR3 和CTPR9。结论 血清CTRP3、CTRP9 水平与ACI 发病密 切相关，可用于ACI 的辅助诊断，且联合检测能提高其诊断的敏感性，为ACI 的早期诊断提供可靠证据。

Abstract:

Objective To study the clinical value of serum CTRP3 and CTRP9 in acute ischemic stroke (AIS). Methods We selected 85 patients with AIS (diagnosed within 24 h) as subjects of observation group, and meanwhile, 80 healthy subjects as control group. Serum CTRP3 and CTRP9 were measured and compared between these 2 groups. Logistic regression model was implemented to fit the joint diagnosis. And the diagnostic value of each index was analyzed by the working characteristic curve of the subjects. Results The serum CTRP3 and CTRP9 in control group were higher than those in observation group (P < 0.05). At the cut-off value as 295.22 ng/ml, the sensitivity, specificity and 95%AUC of CTRP3 were 76.47% (95% CI: 0.658, 0.847), 78.75% (95% CI: 0.679, 0.868), 0.803 (95% CI: 0.751, 0.854), respectively. While the cut-off value of CTRP9 is 282.15ng/ml, the sensitivity, specificity and 95%AUC were 74.12% (95% CI: 0.633, 0.827), 88.75% (95% CI: 0.792, 0.944), 0.763 (0.710, 0.816), respectively. The sensitivity, specificity and 95%AUC of joint diagnostic model were 81.18% (95% CI: 0.709, 0.885), 76.25% (95% CI: 0.652, 0.847), 0.870 (0.832, 0.908), respectively, which were evidently higher than them of CTRP3 and CTRP9. Meanwhile, the AUC of joint diagnosis (0.870) were also higher than them of CTRP3 (0.803) and CTRP9 (0.763). Conclusion Serum CTRP3 and CTRP9 are evidently related to AIS and their joint diagnosis could provide helpful support for the timely diagnosis of AIS.