自发性脑出血患者C反应蛋白水平与血肿量及远期神经功能缺损的关系

C-reactive protein level correlated with hematoma volume and long-term neurological deficits in patients with spontaneous intracerebral hemorrhage

目的观察自发性脑出血(SICH)患者血清C反应蛋白(CRP)水平与早期血肿量及远期神经功能缺损的关系,为指导SICH患者的诊治提供依据。方法选择2017年3月—2018年2月杭州师范大学附属医院治疗的96例SICH患者为观察组,同时选择96例健康体检者为对照组,分别检测观察组入院后第1、3、7天及对照组体检当日血清CRP水平,计算观察组脑出血量,并于出院1年后对其神经功能缺损程度进行评估。结果观察组的小、中和大出血量组分别有45、34和17例。观察组入院后第3天的CRP水平最高,达到(7.84±1.16)mg/L,第7天时降低,为(7.13±1.13)mg/L,但仍高于第1天的(5.27±1.10)mg/L,差异有统计学意义(F=132.366,P<0.001)。入院后第1、3天,不同血量组的血清CRP水平比较差异有统计学意义(均P<0.05)。入院后第1、3和7天,不同神经功能缺损组的血清CRP水平比较差异均有统计学意义(均P<0.05),神经功能缺损中型组和重型组均高于神经功能缺损轻型组,差异有统计学意义(均P<0.05)。结论血清CRP水平与SICH患者早期血肿量及远期神经功能缺损有一定的联系,血清CRP水平升高提示患者血肿量更大,患者发生远期神经功能缺损的风险可能增加。

Objective To observe the relevance of serum C-reactive protein(CRP)level to the early hematoma volume and long-term neurological deficits in patients with spontaneous intracerebral hemorrhage(SICH),and to provide evidence for guiding the diagnosis and treatment of SICH.Methods From March 2017 to February 2018,96 patients with SICH who were admitted to the Affiliated Hospital of Hangzhou Normal University were selected as the observation group,and 96 healthy persons as the control group.The serum CRP levels were measured on the 1 st,3 rd,7 th day after the admission of the observation group and on the day of physical examination of the control group respectively.The amount of cerebral hemorrhage in the observation group was calculated,and the degree of neurological deficit in observation group was evaluated one year after discharge.Results In the observation group,there were 45 cases in the small bleeding group,34 cases in the medium bleeding group,and 17 cases in the large bleeding groups,respectively.The CRP level of the observation group got the highest on the 3 rd day after the admission,which was(7.84±1.16)mg/L,and then decreased to(7.13±1.13)mg/L on the 7 th day,but was still higher than(5.27±1.10)mg/L on the 1 st day(F=132.366,P<0.001).On the 1 st and 3 rd days after the admission,there were significant differences in serum CRP levels among different blood volume groups(all P<0.05).On the 1 st,3 rd and 7 th day after the admission,there were significant differences in serum CRP levels among different neurological deficit groups(all P<0.05).The levels of CRP in medium and severe neurological deficit groups were higher than those in light neurological deficit groups(all P<0.05).Conclusion The serum CRP level is closely related to early hematoma and long-term neurological impairment in patients with SICH.The elevated serum CRP level suggests a larger amount of hematoma and a more likely long-term neurological impairment.