超敏C反应蛋白和纤维蛋白原水平与脑出血短期转归的关系研究

High Sensitive C-reactive Protein,Fibrinogen,and Their Relationship with Short-term Outcome of Intracerebral Hemorrhage

目的:观察脑出血急性期患者血清超敏C反应蛋白(hs-CRP)和血浆纤维蛋白原(FIB)水平与血肿量、脑水肿程度、神经功能缺损程度及短期转归的相关性。方法:40例脑出血患者检测急性期血清hs-CRP和血浆F1B含量,计算入院时及发病3～7天脑内血肿和脑水肿的体积,进行神经功能缺损程度评分(NDS),以发病30天患者的生存或死亡作为患者的短期转归;对照组为体健者40例。结果:脑出血组hs-CRP较对照组明显升高。死亡组与生存组的hs-CRP、血肿量和NDS有显著性差异;FIB差异无显著性。hs-CRP与脑内血肿量、脑水肿程度及NDS呈正相关,FIB与三者无统计学相关。hs-CRP与FIB之间无显著相关。同一患者发病12h内和12～24h之间的hs-CRP水平差异有显著性。结论:发病12～24h之间血清hs-CRP是对脑出血继发性损伤程度的敏感反映,对早期判断预后有一定的参考价值,比FIB的检测更有意义。

Objective：To observe the concentration of high sensitive C-reactive protein （hs-CRP）and fibrinogen（FIB） in blood of patients with acute intracerebral hemorrhage（ICH）. Study their relativity with the volume of haematoma and edema.neumlogie deficit score（NDS） ,and short-term outcome. Methods：The concentration of hs-CRP and FIB was measured in 40 acute primary ICH patients. The volume of haematoma and edema was measured at admission and 3 to 7 days after onset. Stroke severity was assessed by NDS. Short-term outcome was defined with dead or alive at one month. 40 eases of control group were all health people. And then use the date for statistical analysis. Results：The serum concentration of hs-CRP of ICH group was significantly elevated than control group. The hs-CRP level, volume of haematoma and NDS differed significantly between dead group and alive group at one month ,while FIB level had no significant difference between the two groups. The hs-CRP level of ICH patients was positively related to the volume of haematoma and edema and NDS, while FIB level has no statistical relationship with them. The concentration of hs-CRP and FIB has no statistical relationship. The hs-CRP level within 12 hours was differed significantly with the level between 12 hours to 24 hours after onset. Conclusions： The serum concentration of hs-CRP between 12 hours to 24 hours after onset is a sensitive marker to the secondary injury of primary ICH patients. It may he more useful than FIB level to predict the outcome of patients within the first day.