急性脑卒中患者C反应蛋白动态变化与其他因素之间的关系

The correlation between the dynamic change of C-reactive protein and relevant factors in the patients with acute cerebral stroke

目的 探讨急性脑卒中时C反应蛋白（CRP）的动态改变特点与临床生理指标、血生化指标、凝血指标之间的关系，了解急性脑卒中对CRP的影响。方法 选择住院急性脑卒中患者55例（观察组），进行有关临床指标检查和不同时刻CRP的测定。另选在门诊的非脑血管病患者30例（对照组），测定CRP作为对照。结果 观察组患者CRP动态变化显著高于对照组（P=0．0269～0．0006），发病初期CRP的变化与WBC计数、血糖、胆固醇变化显著相关，随后的增高则与年龄、甘油三酯、凝血功能、纤维蛋白原水平等有关，与格拉斯哥意识评分和巴塞尔神经功能评分呈负相关（P〈0．05，P〈0．01）。结论 CRP的动态变化反映了机体损伤的实际状况，可以作为判断急性脑卒中严重程度和预后的有效指标．但这种变化会受到血液中多种因素的影响。

Objectives To investigate the features of C-reactive protein （CRP） dynamic change and their correlation with clinical and laboratory indices and coagulation functions during acute cerebral stroke events, and to explore the impacts of acute cerebral stroke on CRP dynamic change. Methods Fifty-five inpatients（male 27, female 28） with acute stroke were chosen to examine clinical [ blood pressure, Glasgow Coma Scale （GCS）, Barthel Index（BI）, etc. ] and laboratory indices （blood routines, glucose, lipids,etc. ） as well as coagulation functions（INR, AFTT, Fib, PT, TT）. CRP was analyzed at the event onset, 5 and 10 days after the onset. Other 30 outpatients without stroke were chosen as controls. Results The patients with acute stroke had significantly higher levels of CRP than the controls（ P = 0.0269 -0.0006）. At early stage of the events, the increase in CRP was associated remarkably with WBC count, blood glucose and cholesterol, but at late stage, it was related with age, triglyceride, blood coagulation function and fibrinogen. The changes of CRP showed a negative correlation with GCS and BI （ P〈0.05, P〈0.01）. Conclusions CRP may be an effective prognostic marker for cerebral stroke events, but the dynamic change of CRP can be affected by multiple factors of blood.