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Received:June 23, 2022 Published Online:March 20, 2023
Received:June 23, 2022 Published Online:March 20, 2023
中文摘要: 目的 评估血清总同型半胱氨酸（Hcy）、红细胞分布宽度（RDW）水平与卵圆孔未闭（PFO）患者并发隐源性脑卒中（CS）之间的相关性。方法 采用回顾性研究的方法，收集2019年12月至2021年12月于山西医科大学附属第九临床医学院诊断为PFO的住院患者143例，其中非卒中患者71例（非卒中组），CS患者72例（卒中组）。收集并比较两组患者的一般资料及生化指标，采用受试者工作特征曲线（ROC）及ROC曲线下面积（AUC）来评估Hcy和RDW在预测PFO相关性卒中的效能。结果 卒中组Hcy ［19.8（15.0，24.6）μmol/L vs 15.6（12.7，18.2）μmol/L］、RDW［(13.1±1.0)% vs (12.7±0.9)%］显著高于非卒中组（P＜0.01）；高Hcy水平（OR=1.10，95%CI：1.04~1.18，P=0.003）、高RDW水平（OR=1.84，95%CI：1.17~2.89，P=0.008）为PFO患者并发CS的独立相关危险因素；Hcy、RDW预测PFO患者并发CS的AUC分别为0.706和0.673，敏感度为65.28%、65.28%，特异度为83.10%、80.28%。结论 高Hcy水平、高RDW水平与PFO患者并发CS密切相关，Hcy、RDW在预测PFO患者并发CS方面有一定应用价值，其中Hcy的预测效能更好。
Abstract:Objective To evaluate the relationship between the levels of serum total homocysteine (Hcy) and red blood cell distribution width (RDW) and cryptogenic stroke (CS) in patients with patent foramen ovale (PFO). Methods A retrospective study was performed on 143 PFO inpatients in the Ninth Clinical Medical College Affiliated to Shanxi Medical University from December 2019 to December 2021, including 71 non-stroke patients (non-stroke group) and 72 CS patients (CS group). The general data and the blood biochemical indexes were collected and compared between two groups to evaluate the efficacy of Hcy and RDW in predicting PFO-related stroke by using the area under the ROC curve (AUC). Results The levels of Hcy ［19.8 (15.0,24.6)μmol/L vs 15.6 (12.7,18.2)μmol/L］ and RDW［ (13.1±1.0)% vs (12.7±0.9)%］ in CS group were significantly higher than those in non-stroke group (P＜0.01). High Hcy level (OR=1.10, 95%CI:1.04-1.18, P=0.003) and high RDW value (OR=1.84, 95%CI:1.17-2.89, P=0.008) were the independent risk factors for CS in PFO patients. The AUC of PFO patients complicated with CS predicted by Hcy and RDW were 0.706 and 0.673, with sensitivities of 65.28% and 65.28%, specificities of 83.10% and 80.28%, respectively. Conclusion High levels of Hcy and RDW are closely related to CS in patients with PFO. Both Hcy and RDW have certain application value in predicting CS, and Hcy has a better prediction efficiency.
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基金项目:山西省医学重点科研项目（2021XM14）；山西省重点研发计划项目（201903D321226）
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