老年人急性脑梗死患者血清C反应蛋白含量的动态变化及临床意义

Dynamic change and its clinical significance of serum C-reactive protein content in patients with acute cercbral infarction

目的探讨急性脑梗死(ACI)患者血清C反应蛋白(CRP)含量的动态变化及其临床意义。方法检测50例ACI患者发病<48h、第3天和第5天的血清CRP含量,按牛津郡社区卒中项目(OCSP)和CT分型对患者的血清CRP含量进行比较,并分析其与病情、预后的关系。结果血清中CRP浓度改变具有以下特征:发病后48小时内CRP水平升高并明显高于正常对照组(P<0.05),第3天和第5天仍继续上升,病情严重,梗死范围面积大,皮层加皮层下梗死者或完全前循环梗死者均较其他病例明显升高(P<0.05～P<0.01),与国立卫生研究所卒中量表(NIHSS)评分对比分析呈显著正相关(r=0.412,P<0.01)。结论ACI后血清CRP含量的变化可反映病灶大小和病情的严重程度,为指导临床的诊治提供依据。

Objective To investigate the dynamic change and its clinical significance of serum C-reactive protein （CRP） content in patients with acute cerebral infarction （ACI）. Methods The serum specimens of 50 cases of ACI were consecutively collected in 48 hours and at 3rd, 5th day after onset, and the concentration of CRP was examined. According to Oxford community strok project （OCSP） and CT classification the serum levels of CRP were compared with each patient＇s condition and prognosis of other, and the relationships disease were analyzed. between serum CRP levels , Results The main points of the change of serum CRP content in the cases of ACI were as the fellows： The serum CRP level was markedly elevated in 48 hours after onset of ACI （13.25 ± 7.41 vs 5.38 ± 2.13 P〉0.01）, and at the 3rd and 5th day was still higher than that in normal control. The level of CRP in the patients, who were severe form of condition, large infarct size, cortical and infracortical infarct, or whole anterior circulation infarct , were significantly higher than the other cases （P 〉 0.05-P〈0.01）. CRP level was rellated with score of the NIH stroke scale （NIHSS）（r=0.412, P〈0.01）. Logistic regression analysis suggest serum CRP in acute stage as anindependent indicator of prognosis. Conclusion The serum CRP level can reflect the size of lesion and severity of ACI, and give the informtion about diagnosis and treatment among clinical work.