脑梗死继发肺部感染患者血清CRP和Hcy与病情严重程度及预后的关系

Relationship between serum CRP and Hcy and disease severity and prognosis of patients with pulmonary infection secondary to cerebral infarction

目的分析脑梗死继发肺部感染患者血清C反应蛋白(CRP)、同型半胱氨酸(Hcy)与病情严重程度及预后的关系。方法收集2019年5月-2021年5月于华北医疗健康集团石家庄华药医院治疗的184例脑梗死继发肺部感染患者的临床资料。根据病情严重程度,使用美国国立卫生研究院卒中量表(NIHSS)评分将其分为重度组(NIHSS>15分,n=69)、中轻组(NIHSS≤15分,n=115)。比较两组患者血清CRP、Hcy水平差异,分析血清CRP、Hcy与患者病情严重程度的相关性。根据其不同预后情况,使用改良Rankin评分量表(m RS)评分将重度脑梗死继发肺部感染组分为预后优良组(mRS≤2级,n=24)、预后不良组(mRS>2级,n=45)。采用受试者工作特征(ROC)曲线,分析血清CRP、Hcy对重度脑梗死继发肺部感染患者预后的预测效能。结果重度组患者血清CRP[(29.76±6.18)mg/L vs.(20.92±7.55)mg/L]、Hcy[(25.61±8.13)μmol/L vs.(18.29±7.47)μmol/L]水平明显高于中轻组,差异均有统计学意义(P均<0.05)。患者血清CRP、Hcy与病情严重程度及预后均成正相关(NIHSS:r_(CRP)=0.643、r_(Hcy)=0.601,mRS:r_(CRP)=0.582、r_(Hcy)=0.564,P均<0.05)。血清CRP、Hcy曲线下面积分别为0.843和0.863,均明显大于参考线(P均<0.05),其cut-off值分别为26.89 mg/L、24.46μmol/L。结论脑梗死继发肺部感染患者血清CRP、Hcy与病情严重程度及预后关系紧密,其水平越高反映患者病情越严重,且还能有效预测患者预后,具有较高临床应用价值。

Objective To analyze the relationship between serum C-reactive protein(CRP)and homocysteine(Hcy)and disease severity and prognosis of patients with pulmonary infection secondary to cerebral infarction.Methods The clinical data of 184 patients with pulmonary infection secondary to cerebral infarction treated in the hospital between May 2019 and May 2021 were analyzed.According to the disease severity evaluated by National Institutes of Health Stroke Scale(NIHSS)score,the patients were divided into severe group(NIHSS>15 points,n=69)and moderate-to-mild group(NIHSS≤15points,n=115).The differences in levels of serum CRP and Hcy were compared between the two groups,and the correlation between serum CRP,Hcy and disease severity of patients was analyzed.According to the different prognosis status,the patients in severe pulmonary infection secondary to cerebral infarction were classified as good prognosis group(mRS≤grade2,n=24)and poor prognosis group(mRS>grade 2,n=45)by the modified Rankin Scale(mRS).ROC curve was used to analyze the predictive efficiency of serum CRP and Hcy on the prognosis of patients with pulmonary infection secondary to cerebral infarction.Results The levels of serum CRP[(29.76±6.18)mg/L vs.(20.92±7.55)mg/L]and Hcy[(25.61±8.13)μmol/L vs.(18.29±7.47)μmol/L]of patients in severe group were significantly higher than those in mild group(P<0.05).Serum CRP and Hcy of patients were positively correlated with disease severity and prognosis(P<0.05).The AUC values of serum CRP and Hcy curves were significantly larger than the reference line(P<0.05),and their cut-off values were 26.89mg/L and 24.46μmol/L,respectively.Conclusions Serum CRP and Hcy of patients with pulmonary infection secondary to cerebral infarction were closely related to the disease severity and prognosis.The higher the levels,the more serious the disease condition of patients.Serum CRP and Hcy levels could effectively predict the prognosis of patients and had high clinical application value.