Explore The Practicability Of The Biomarkers Which Can Auxiliary Examinate The Acute Cerebral Infartion

Objective:Research on Acute cerebral infarction(Acute cerebral infarction, ACI) patients with auxiliary examination biomarkers is various for the clinical practicability of each marker lack of system evaluation, using ROC curve analysis in the peripheral blood plasma Homocysteine(Homocysteine, Hcy), endothelial nitric oxide synthetase(endothelial nitric oxide synthase and e NOS) regulatory proteins, soluble thrombosis(soluble thrombomodulin, s- TM), hypersensitive c-reactive protein(high sensitivity C- reactive protein, the hs- CRP) and von Willebrand factor(von Willebrand factor, v WF) detection indexes such as plasma sensitivity and specificity in the diagnosis(ACI), and analyze the Hcy levels with the correlation of CRP and v WF, used for clinical auxiliary examination ACI.Methods:1, Collecting 150 acute cerebral infarction patients(observation group) with 71 males and 79 females aged 48 to 82 years old(average 67.39 ±8.25 years old). Cases are in conformity with the following diagnostic criteria:(1) the Chinese medical association in 1995 the fourth national conference on cerebrovascular disease correction of the various cerebrovascular disease diagnosis and diagnosed by head CT and/or MRI examination;(2) within 72 h after the onset of admission;(3) neural function defect scale in patients with between 16 and 30 points. Another health check-up 50 cases as control group, 25 cases of male, female 25 cases, aged 45 to 76 years old, with an average of 63.21±11.45 years old.Using Japan’s HITACHI HITACHI 7180 automatic biochemical analyzer, enzymatic determination of plasma Hcy application cycle; Finland labsystems company Multiskan MK3 enzyme standard instrument, using enzyme-linked immune double antibodies sandwich(ELISA) method for the determination of plasma s TM and e NOS; American beckman coulter company IMMAGE 800 double optical path immune turbidity analyzer, immune turbidimetric method to determine the plasma hs- CRP; French STAGO company STA- compact fully automatic blood coagulation instrument, enzyme standard method to detect v WF.2, Plasma Hcy of acute cerebral infarction patients and healthy controls, e NOS, s TM, hs CRP and v WF level ROC curve drawing test results, diagnostic test evaluation, calculation of sensitivity, specific, misdiagnosis rate, missed diagnosis, negative predictive value and positive predictive value, the use of statistical software diagnostic test diagnosis threshold calculation, evaluation of five kinds of diagnostic test accuracy.3, Choose 150 cases of patients with acute cerebral infarction(observation group) and requirements according to different divided into three groups, higher Hcy levels of Hcy concentration respectively 10 to 30 mu mol/L group; Hcy concentration of 30 to 50 mu mol/L group; Hcy concentration > 50 mu mol/L group. 68 cases 68 cases of male, female, aged 48 to 82 years old, average(68.39-10.54). Conform to the diagnostic standard of patients. 50 cases of healthy control group, 25 cases of male, female 25 cases, aged 35 to 70 years old, average(53.21-12.13).Choose Japan HITACHI HITACHI 7180 automatic biochemical analyzer, enzymatic determination of plasma Hcy application cycle; Choose a beckman coulter company IMMAGE 800 double optical path immune turbidity analyzer, application of immune turbidimetric method to determine the plasma hs- CRP; Selection of French STAGO company STA- compact fully automatic blood coagulation instrument, application of enzyme standard method to detect v WF.Results:1.Plasma Hcy and eNOS, patients with acute cerebral infarction, sTM, hs- CRP and v WF were significantly higher than that of healthy controls(P < 0.05).2, In the area under the ROC curve were 0.938, 0.873, 0.879, 0.922 and 0.786. According to the ROC curve is obtained when the Hcy critical value of 9.11 mu mol/L diagnostic sensitivity specificity of 76% to 95.2%; The hs- CRP threshold is 3.38 mg/L when the diagnostic sensitivity of 81.9%, specificity of 90% ENOS critical value of 437.30 mu mol/L diagnostic sensitivity specificity of 96% to 79%; STM critical value of 7.43 mu mol/L diagnostic sensitivity of 75.2%, specificity of 96% VWF critical value of 194.85 ng/ml diagnostic sensitivity to 75.2% specificity of 75.2%.3, In the patients who with acute cerebral infarction group: Hcy moderatelyelevated group(Hcy concentration 10 to 30 mu mol/L) of Hcy level was 19.26 ± 4.74, the hs- CRP level was 5.24 ± 0.88, v WF level was 240.52 ± 43.82, were significantly higher than that of normal control group; Hcy moderately elevated group(Hcy concentration 30-50 mu mol/L) of Hcy level was 42.04 ±7.09, the hs- CRP level was 7.06 ±0.42, v WF level was 345.09 ± 12.85, were significantly higher than that of normal control group; Higher Hcy severe group(Hcy concentration > 50 mu mol/L) of Hcy level was 56.32 ± 6.49, the hs- CRP level was 8.08 ± 0.24, v WF level was 384.89 ±20.90, were significantly higher than that of normal control group. In the study of correlation, Hcy and hs- CRP correlation coefficient is 0.804; Hcy and v WF correlation coefficient is 0.780, are positively correlated.Conclusion:1 In patients with acute cerebral infarction plasma Hcy, e NOS, s TM, hs- v WF and CRP levels were significantly higher than that of normal control group. Plasma Hcy, e NOS, s TM, hs- CRP and v WF level can be used as auxiliary indexes in diagnosis of acute cerebral infarction.2 ROC curve evaluation, Plasma Hcy, eNOS, sTM, hs- CRP and vWF test, results of Hcy diagnostic test accuracy is the highest, the hs- CRP second, e NOS, s TM, v WF diagnosis accuracy of medium.3 Analysis of acute cerebral infarction patients with elevated serum Hcy and hs-CRP and v WF correlation, results in patients with acute cerebral infarction was significantly higher than that of healthy controls.