急性脑梗死患者hs-CRP含量的变化、临床意义及相关性研究

Changes,Clinical Significance and Correlation of Serum High Sensitivity C-reactive Protein Levels in Patients with Acute Cerebral Infarction

目的探讨急性期脑梗死患者高敏C反应蛋白（hs-CRP）含量的变化和临床意义,以及其与传统脑梗死危险因素（如血压、血脂、血糖等）的关系,为脑梗死的治疗和判断预后提供实验依据.方法用全自动生化分析仪测定53例脑梗死患者发病3 d内的hs-CRP水平,部分患者第7天复查hs-CRP,同时记录患者入院时的神经功能缺失评分（CNDF）、年龄、收缩压、舒张压、血脂、血糖、纤维蛋白原.同时测定23例有脑梗死危险因素而未发生脑梗死的患者（对照A组）及30例健康人（对照B组）的hs-CRP水平.结果急性脑梗死组比对照组A、对照组B的hs-CRP明显升高（P〈0.01）,对照组A比对照组B的hs-CRP增高,差异有意义（P〈0.05）;急性脑梗死组与复查组hs-CRP值比较,差异无显著性（P〉0.05）,复查组与对照组A、对照组B比较,差异有意义（P〉0.05）;重型脑梗死的hs-CRP水平明显高于中型、轻型（P〈0.05）,中型脑梗死的hs-CRP水平高于轻型,差异有意义（P〈0.05）,作Pearson相关分析发现,hs-CRP与病情轻重呈正相关关系;hs-CRP与收缩压、纤维蛋白原、血糖、总胆固醇呈正相关关系,而与年龄、舒张压、甘油三酯、高密度脂蛋白、载脂蛋白AI、载脂蛋白B无相关性；以hs—CRP为应变量，其他指标为自变量的多元回归分析显示，脑梗死、FIB、血糖、收缩压是hs-CRP的主要影响因素，差异有显著性意义．结论hs-CRP可作为判断病情的一种手段，与脑梗死的危险因素密切相关，可以作为脑梗死发生的一种预测因子．hs—CRP与收缩压、纤维蛋白原、血糖、总胆固醇呈正相关关系，是优于其他因素的综合性的判断指标．

Objective This study mainly investigates the changes of serum high sensitivity C-reactive protein （hs-CRP） levels,clinical significance and the relationship between the hs-CRP and the risk factors （blood pressure,blood glucose） in patients with acute cerebral infarction. Method The levels of serum hs-CRP was measured by the automatic bio-chemical analysis instrument in 53 patients with ACI in 3 d,23 patients（control A） who had risk factors of cerebral infarction had not developed cerebral infarction and hs-CRP level of 30 healthy subjects（control B） were measured. Parts of the patients checked bs-CRP in the 7th day again. All the ACI patients were scored by CNDF bases on deficit in their clinical neurological function and examined the age,SBP,DBP,blood-fat,blood glucose and FIB. The relationship between concentration of hs-CRP and the risk factors of cerebral infarction was analyzed. Results The level of hs-CRP increased in the acute cerebral infarction patients. The differences were significant （P 〈 0.05）. The level of serum hs-CRP in control A was higher than that in control B （P 〈 0.05）. The hs-CRP level in checked group was not different from the acute infarction group （P 〉 0.05）. It was significantly higher in checked group than control A and B. There were correlations between the levels of hs-CRP and the degree of nerve damage,SBP,the level of blood glucose,FIB and total cholesterol. And SBP,blood glucose and FIB were the mainly affecting factors. Conclusion hs-CRP was related with the risk factors of cerebral infarction and may be a predictive factor of the occurrence of cerebral infarction, hs-CRP was used to estimate the severity of cerebral infarction. There were correlations between the hs-CRP and SBP,the levels of blood glucose and total cholesterol, hs-CRP was an integrated judgment factor and better than others.