Diagnostic values of serum homocysteine and C-reactive protein in patients with acute cerebral infarction

Wang Daping; Li Lin; Yin Jilai

doi:10.3760/j.issn.1673-4777.2020.04.020

Abstract：Objective To explore the values of serum homocysteine(Hcy) and C-reactive protein(CRP) in clinical diagnosis of acute cerebral infarction. Methods From January 2018 to April 2019, 70 patients diagnosed as acute cerebral infarction in the First Affiliated Hospital of Hainan Medical College were enrolled as observation group, including 25 cases of large infarction( >3. 0 cm), 30 cases of medium infarction(1. 5-3. 0 cm) and 15 cases of small infarction( <1. 5 cm);70 healthy people were enrolled as control group. Serum levels of Hcy and CRP were detected. Diagnostic values of Hcy and CRP for acute cerebral infarction were analyzed using imaging examination as standard criteria. Results Serumlevels of Hcy and CRPin observation group were significantly higher than those in control group[(19. 62 ± 2. 41)μmol/L vs (4. 47 ± 0. 22)μmol/L, (15. 7 ± 1. 6) mg/L vs (2. 9 ± 1. 5)mg/L](both P<0. 001). Higher levels of Hcy and CRP were observed with greater infarction area (all P <0. 05). Combined Hcy and CRP in diagnosis of acute cerebral infarction showed higher accuracy, specificity, sensitivity, positive predictive value, negative predictive value[91. 4％(64/70) vs 61. 4％(43/70), 67. 1％(47/70);85. 0％(17/20) vs 60. 0％(12/20), 70. 0％(14/20);94. 0％(47/50) vs 62. 0％(31/50), 66. 0％(33/50);94. 0％(47/50) vs 79. 5％(31/39), 84. 6％(33/39);85. 0％(17/20) vs 38. 7％(12/31), 45.2％(14/31)] and lower rates of missed diagnosis and misdiagnosis[6. 0％(3/50) vs 38. 0％(19/50), 34. 0％(17/50);15. 0％(3/20) vs 40. 0％(8/20), 30. 0％(6/20)] than separate detection(all P<0. 05). Conclusion Detection of serum Hcy and CRP is valuable in clinical diagnosis of acute cerebral infarction and evaluating the severity of disease;combined detection of the two indicators shows better efficiency.