目的 探讨脑小血管病患者血清碱性磷酸酶（ALP）和淀粉样蛋白A（SAA）与脑微出血（CMBs）的相关性。 方法 选取安徽省第二人民医院神经内科204例脑小血管病患者作为研究对象。根据是否发生脑微出血分为CMBs组117例和非CMBs组87例。比较两组患者的基线资料。识别脑微出血的危险因素，比较CMBs组不同程度和不同部位血清ALP和SAA水平。探讨二者是否与脑微出血的严重程度存在关联，并评估对脑微出血的诊断价值。 结果 CMBs组年龄、高血压比例、血清ALP、SAA水平均高于非CMBs组（P < 0.05）。logistic回归分析提示年龄、高血压、血清ALP、SAA水平均为脑微出血的独立危险因素（P < 0.05）。血清ALP和SAA单独和联合预测脑微出血的AUC值分别为0.801、0.813、0.914，联合预测价值高于单独预测价值。相关分析显示，二者与脑微出血严重程度呈正相关（P < 0.001），二者与脑微出血不同部位比较，差异无统计学意义（P > 0.05）。 结论 脑小血管病患者血清ALP和SAA升高与脑微出血密切相关，早期联合检测可有效预测脑微出血发生风险。

Objective To exploring the correlation of serum alkaline phosphatase （ALP） and amyloid A protein（SAA） levels with cerebral microbleeds （CMBs） in patients with cerebral small vascular disease. Methods The study involved 204 patients with cerebral small vascular disease from the neurology department of Anhui No.2 Provincial People's Hospital. According to whether cerebral microbleeds occurred， they were categorized into a CMBs group（n = 117）and a non-CMBs group（n = 87）. The baseline data of two groups of patients were campared. The risk factors of cerebral microbleeds were identified and the serum ALP and SAA leves in the CMBs group across different degrees and locations were compared. Correlation analysis was used to investigate the correlation between the serum ALP， SAA levels， and the severity of cerebral microbleeds.ROC curves was used to evaluate their diagnostic value for cerebral microbleeds. Results Age， hypertension rate， serum ALP and SAA levels in the CMBs group were higher than those in the non-CMBs group （P < 0.05）. Logistic regression analysis showed that age， hypertension， serum ALP， and SAA levels were independent risk factors for cerebral microbleeds （P < 0.05）. ROC curves showed that the AUC values of serum ALP and SAA alone for predicting cerebral microbleeds were 0.801， 0.813.If in combination， the AUC value was 0.914 which is higher. Correlation analysis showed that the serum ALP and SAA levels were positively correlated with the severity of cerebral microbleeds （P < 0.001）， Meanwhile， there was no statistically significant difference between the serum ALP and SAA levels and different locations of cerebral microbleeds （P > 0.05）. Conclusions Elevated serum ALP and SAA levels in patients with cerebral small vessel disease are closely related to cerebral microbleeds. Early combined detection can effectively predict the risk of cerebral microbleeds.