摘要:目的 探讨血清同型半胱氨酸（Hcy）和脂蛋白(a)[ Lp(a)] 单项与联合检测在脑出血（ICH）诊断中的应用价值。 方法 选择145例ICH组患者、150名健康对照组，用循环酶比色法定量测定血清Hcy，用胶乳增强免疫透射比浊法平行检测Lp(a) 。经统计分析，评价Hcy单项与联合Lp(a)检测对ICH诊断的敏感度。 结果 ICH组血清Hcy为18.03（13.41~25.63）µmol/L，对照组为11.25（9.06~13.42）µmol/L，经非参数检验，两组间差异有统计学意义（U=9.76，P＜0.01）；ICH组血清Lp(a)为238.00（120.50~411.00）mg/L, 对照组为153.00(103.50~225.50) mg/L，两组间差异有统计学意义（U=5.24，P＜0.01）。ICH组Hcy阳性率为 [51.7%(75/145)]，Lp(a)的阳性率为[40.7%(59/145) ]，两指标联合检测脑出血的阳性率[71.7%(104/145)]，高于单项Hcy (2=28.37，P＜0.05) 或 Lp(a) (2=12.28，P＜0.01)。 结论 脑出血患者与对照组比较，血清Hcy和 Lp(a)的浓度均有大幅增高，两指标联合检测可提高脑出血的诊断敏感度。

Abstract：Objective To explore the clinical application value of alone and combined detection of Homocysteine (Hcy) and Lipoprotein (a) [Lp(a)] in the diagnosis of intracerebral haemorrhage (ICH). Methods 145 ICH patients and 150 healthy controls were involved in this study. The serum Hcy were detected by an enzymatic cycling assay and serum Lp(a) were measured by latex enhanced immuno-turbidimetric assay. The sensitivity of each parameter in single and combining detection were evaluated. Results The serum Hcy levels in ICH group was 18.03 (13.41～25.63) µmol/L, and the control group was 11.25(9.06～13.42) µmol/L. There were statistical differences between two groups (U=9.76，P＜0.01).The concentration of Lp(a) in ICH group was 238.00 (120.50~411.00) mg/L, and the control group was 153.00 (103.50~225.50) mg/L. There were statistical differences between two groups (U=5.24，P＜0.01). The positive rate of Hcy and Lp(a) detected alone in ICH group were 51.7% and 40.7% respectively. The positive rate of ICH in combined detection of Hcy and Lp(a) was much higher than that of Hcy or Lp(a) alone detection (P＜0.01. Conclusion The combined detection of Hcy and Lp(a) could improve the sensitivity of diagnosis of ICH.