青年脑梗死患者血清C反应蛋白及血脂和血液流变学特征

Serum C-reactive protein,blood lipid and hemorheology characteristics in the young patients with cerebral infarction

目的:观察青年脑梗死患者血清急性相反应蛋白C反应蛋白水平,以及血脂和血液流变学的变化特征。方法:选择2001-01/2004-12汕头大学医学院第一附属医院收治的脑梗死患者101例,按年龄分为青年组(<40岁)36例,老年组(>60岁)65例。另设对照组50例,均为健康人,平均年龄与青年组比较无差异。脑梗死患者于发病后第1天清晨空腹抽血,对照组也是清晨空腹抽血,测定血清C反应蛋白和血液流变学和血脂各指标(血小板黏附率、凝血酶原时间、凝血因子Ⅰ、胆固醇、三酰甘油、载脂蛋白A1和B)。结果:按意向处理分析,151例被试者的资料均进入结果分析。①血清C反应蛋白水平:青年组和老年组均高于对照组[(22.48±5.44),(15.39±4.31),(6.03±2.14)mg/L,P<0.01],其中青年组又高于老年组(P<0.05)。②血清C反应蛋白升高的发生率:以对照组为参照,青年组高于老年组(44%,31%,P<0.05)。③血液流变学和血脂检测:脑梗死组和对照组比较,纤维蛋白原,血小板黏附率升高,凝血酶原时间缩短,三酰甘油及胆固醇升高(P<0.01),但脑梗死青年组和老年组间对比无明显差别(P>0.05)。结论:血清C反应蛋白水平的增高是脑梗死的危险因素,特别是青年性脑梗死的重要危险因素,C反应蛋白增加可以激活凝血纤溶系统及血小板凝聚功能,可能会对脑梗死的发生和病后的整个过程产生强烈的影响,故可作为青年性脑梗死的病情和预后的判断指标之一。

AIM:To observe serum level of acutephase reactive protein,Creactive protein,and the characteristic changes of blood lipid and blood hemorheology in young patients with cerebral infarction.METHODS:The subjects were 101 patients selected from those with cerebral infraction hospitalized in the First Affiliated Hospital of Shantou University Medical College from January 2001 to December 2004.According to their age,they were divided into young group(less than 40 years old,n=36) and elderly group(more than 60 years old,n=60).Another 50 healthy people were selected as the controls,whose mean age was similar to the young's.Fasting blood was drawn from the patients on the first morning after the attack of cerebral infraction,and also from the healthy people in the morning.The serum level of Creactive protein was detected,followed by the assessment of indexes of hemorheology and blood lipid in terms of adhesion rate of blood platelets,time for prothrombin,coagulation factor Ⅰ,cholesterol,triacylglycerol,apolipoprotein A1 and B.RESULTS:According to the intentiontotreat,the data of all the 151 subjects were involved in the result analysis.①The serum level of Creactive protein was significantly higher in the young group[(22.48±5.44) mg/L] and elderly group[(15.39±4.31) mg/L] than in the control group[(6.03±2.14) mg/L](P< 0.01),and also higher in the younger group than in the elderly group.②The incidence of increase of Creactive protein level was higher in the young group(44%) than in the elderly group(31%) by using the control group as the control(P< 0.05).③As compared with the control group,fibrinogen level and adhesion rate of blood platelets were increased,the time for prothrombin was shortened,and the content of triacylglycerol and cholesterol was also increased in the other two groups(P< 0.01).However,the indexes of hemorheology and blood lipid were insignificantly different between the young group and the elderly group(P >0.05).CONCLUSION:The increase of serum Creactive protein level is one of risk factors of cerebral infarction,especially for the young patients with cerebral infarction.The increase of Creactive protein level can activate coagulation and plasminogen systems,as well as coagulation of blood platelets,which then remarkably influences the attack of cerebral infarction and the whole pathological process after cerebral infarction,therefore,it can be a predictor for the development and prognosis of cerebral infarction in the young.