进展性与非进展性缺血性脑卒中患者血清hs-CRP和血浆D-二聚体水平变化的对比研究

Contrastive study on changes of high sensitive C-reaction protein and D-dimer of patients with progressive and non-progressive ischemic stroke

目的研究进展性与非进展性缺血性脑卒中患者血清hs-CRP和血浆D-二聚体(D-dimer)水平变化,为进展性缺血性脑卒中的预测及治疗提供科学依据。方法采用酶联免疫吸附试验(ELISA)法、免疫散射比浊法对50例非进展性缺血性脑卒中、40例进展性脑卒中患者及对照组不同相应时间点的血液进行D-dimer和hs-CRP水平检测,并对结果进行比较,对缺血性脑卒中组患者相应的神经功能缺损情况进行斯堪地那维亚量表(SSS)评分。结果进展组的D-dimer水平顺序依次为:发病第7天>3天>24 h内>14天,在发病1周内,进展组D-dimer水平均明显高于非进展组(P<0.01);进展组的hs-CRP水平顺序依次为:发病第3天>7天>24 h内>14天,发病第3天和7天,进展组明显高于非进展组(P<0.叭);进展组发病3周时神经功能缺损恢复较非进展组为差(P<0.01)。结论血清hs-CRP和血浆D-dimer的升高与进展性缺血性脑卒中的发生密切相关,可作为进展性脑卒中的预测指标。

Objective To provide a scientific basis for prediction of progressive ischemic stroke through contrastive study on changes of high sensitive C-reaction protein and D-dimer of patients with progressive and patients with non- progressive ischemic stroke. Methods Serum high sensitive C-reaction protein and D-dimer at different corresponding time points in above-mentioned two groups of patients and controlled healthy people were detected by immunonephelometric assay and enzyme-linked immunosorbentassay（ELISA） ,and the results were compared. The resulting neurological deficit of patients with acute ischemic stroke were judged according to the Scandinavian Stroke Scale （SSS）. Results The order of D-dimer level in progressive ischemic stroke group was that 7d after the onset 〉 3 d after the onset 〉 within 24 h after the onset 〉 14 d after the onset. D-dimer level in progressive ischemic stroke group was significantly higher than non- progressive ischemic stroke group during 1 w after the onset（ P 〈 0.01 ）. The order of high sensitive C-reaction protein level in progressive ischemic stroke group was that 3 d after the onset 〉 7 d after the onset 〉 within 24 h after the onset 〉 14 d after the onset. High sensitive C-reaction protein level in progressive ischemic stroke group was significantly higher than non- progressive ischemic stroke group on 3 d and 7 d after the onset （P 〈0.01 ）. The return of the resulting neurological deficit of progressive ischemic stroke was worse than non- progressive ischemic stroke group at the end of 3 w（P 〈 0.01 ）. Conclusion Elevated high sensitive C-reaction protein and D-dimer levels are closely related to the occurrence of progressive ischemic stroke and could be a prediction index of progressive ischemic stroke.