急性脑梗死患者血清C-反应蛋白和神经元特异性烯醇化酶水平变化及相关性研究

Changes of serum C-reactive protein and neuron-specific enolase levels in patients with acute cerebral infarction and relative study

目的 观察急性脑梗死（ACI）发病早期血清CRP和神经元特异性烯醇化酶（NSE）水平变化与病情严重程度的关系以及两者的相关关系。方法 检测60例ACI患者（ACI组）以及40例健康体检者（对照组）的血清CRP、NSE水平，采用美国国立卫生院卒中量表（NIHSS）对ACI患者入院时的临床神经功能损害程度进行评价，比较CRP、NSE水平在不同大小梗死灶及不同临床神经功能损害程度中的差异，并与对照组比较。结果 ACI组血清CRP、NSE水平与对照组比较显著增高[（6．95±2．34）mg／L比（2．21±1．05）mg／L，（22．39±4．72）μg／L比（7．16±2．63）μg/L，P均〈0．01]。梗死灶越大、临床神经功能损害程度越重，血清CRP、NSE水平越高。血清CRP、NSE水平分别与NIHSS评分呈正相关（r=0．51、r=0．44，P均〈0．01）。血清CRP水平与NSE水平呈正相关（r=0．57，P〈0．01）。结论 ACI发病早期血清CRP、NSE水平变化可反映梗死灶大小和临床神经功能损害的严重程度。CRP、NSE水平均可作为ACI患者病情评估的重要生物学指标。

Objective To investigate the changes of serum C-reactive protein （CRP） and neurun-specific enolase（ NSE ）levels in patients with acute cerebral infarction （ACI） and their relations with infarct size, severity of neurological impairment. Methods The levels of serum CRP, NSE were measured in 60 patients （ACI group） within 72 hou~ after infarction and 40 normal controls （control group）. The severity of neurological impairment of patients with ACI was assessed by National Institutes of Health Stroke Scale （NIHSS） at admission. Results The mean levels of serum CRP and NSE in ACI group were higher than those in control group, （6.95 ± 2.34） mg/L vs （2.21 ± 1.05）mg/L, P 〈 0.01, （22.39 ± 4.72） tr g/L vs （7.16± 2.63 ）μg/L, P 〈 0.01, respectively. Higher levels of CRP and NSE were obviously associated with larger infarct size and more severe neurological impairment. The changes of CRP and NSE levels correlated with scores of NIHSS （r = 0.51, r = 0.44, all P 〈 0.01 ） significantly. CRP levels were positively correlated with those of NSE （r = 0.57, P 〈 0.01 ）. Conclusion The levels of serum CRP and NSE can be used as an important biological marker to estimate the size of infarct and the severity of neurological impairment in ACI.