脑梗死急性期超敏C反应蛋白水平与神经功能恢复的关系

Association between high-sensitivity C-reactive protein in acute phase of ischemic stroke with functional outcome

目的探讨脑梗死急性期超敏C反应蛋白(hs-CRP)水平与脑梗死神经功能恢复的关系。方法选取发病72h内的急性脑梗死患者269例,入院第2天测定hs-CRP,按hs-CRP水平分为低hs-CRP组(hs-CRP≤3mg/L)及高hs-CRP组(hs-CRP>3mg/L),比较2组患者的临床资料,分析影响hs-CRP水平的因素;入选患者进行90d随访,比较2组患者90d时神经功能恢复情况(改良Rankin量表评分3～6分为恢复不良),分析影响神经功能恢复的因素。结果 共266例患者完成随访,hs-CRP中位数3.15mg/L(1.12～8.89mg/L)。高hs-CRP组(138例)年龄较大(P<0.001),糖尿病发病率较高(P=0.001),房颤发病率较高(P=0.004),入院时脑梗死较严重(P=0.003);高龄、合并糖尿病及房颤、入院时脑梗死严重程度与hs-CRP水平高独立相关(P均<0.05);高hs-CRP组神经功能恢复不良比例高于低hs-CRP组(P<0.001);hs-CRP升高与神经功能恢复不良独立相关(OR1.213,P=0.001,Logistic分析)。结论 高龄、糖尿病史、房颤病史、脑梗死严重程度重可能是hs-CRP升高的独立危险因素;hs-CRP升高可能是神经功能恢复不良的独立危险因素。

Objective To explore the association between high-sensitivity C-reactive protein（hs-CRP） in acute phase of ischemic stroke with functional outcome.Methods Two hundred and sixty-nine patients with acute ischemic stroke who were admitted within 72 hours after the onset of symptoms were entered the study.hs-CRP was measured on the next day after admission.The patients were divided into two groups： higher hs-CRP group and lower hs-CRP group.The clinical data were compared within two groups and the probably factors to affect hs-CRP were analyzed.The functional outcome（poor outcome was defined as a score of 3 to 6 on the modified Rankin scale） were compared and the probably factors to affect functional outcome were analyzed.Results Two hundred and sixty-six patients were included in the present study.The median CRP was 3.15 mg/L.The patients with higher hs-CRP were older,more often with diabetes and atrial fibrillation,and severe stroke（P0.001,P=0.001,0.004,0.003,respectively）.Age,diabetes and atrial fibrillation,and stroke severity（NIHSS） were independently associated with hs-CRP（P0.05）.The patients with higher hs-CRP had poor functional outcome（P0.001）.High hs-CRP was independently associated with poor functional outcome（OR 1.213,P=0.001,Logistic regression）.Conclusion Age,diabetes and atrial fibrillation,and stroke severity are associated with hs-CRP.High hs-CRP is associated with poor functional outcome.