超敏C反应蛋白与出血性脑卒中的1∶2匹配病例对照研究

A case-control study of high sensitive C-reactive protein level and hemorrhagic stroke

目的:探讨超敏C反应蛋白(hs-CRP)水平变化与出血性脑卒中的关系。方法:收集盐城市第一人民医院2009年住院的出血性脑卒中患者149例,同时选择同地区参与健康调查的社区人群作为对照,按同性别、同年龄(±2岁)进行1∶2匹配,共选择了298例非脑卒中对象作为对照。采用统一的流行病学调查表收集基本资料、个人疾病史,同时检测血压和血糖、血脂和hs-CRP等生化指标,应用Cox回归模型进行分析。结果:病例组hs-CRP水平显著高于对照组(P<0.001);校正高血压史、糖尿病史、血糖和血脂升高等危险因素后,hs-CRP每升高1 mg/L的OR值(95%CI)为1.386(1.230～1.563),P<0.001;而hs-CRP升高(≥3 mg/L)的OR值(95%CI)为6.599(3.141～13.867),P<0.001。进一步按性别分层分析结果显示,男性hs-CRP升高(≥3 mg/L)者脑出血的患病风险高于女性,OR值(95%CI)分别为8.675(3.206～23.469)、3.836(1.106～13.308),P值分别为<0.001、<0.05。结论:hs-CRP升高与出血性脑卒中存在显著关联,且男女hs-CRP升高与出血性脑卒中的关联存在差异。

Objective：To investigate the association of plasma high sensitive C-reactive protein（hs-CRP） level and hemorrhagic stroke（HS）.Methods：A case-control study（1∶2 matched） was conducted and 149 patients with acute cerebral hemorrhage from a county hospital and 298 age-and sex-matched controls from community-based population were selected in 2009.A unified questionnaire was managed to collect demographic information and history of disease.Blood pressure was measured and fasting glucose,plasma lipid and hs-CRP were detected.Cox model regression was applied to evaluate the association of hs-CRP level and hemorrhagic stroke.Results：The level of plasma hs-CRP in HS cases was significantly higher than that of controls（P 0.001）.The association of hs-CRP and HS was statistically significant and OR（95%CI） was 1.386（1.230～1.563） for per 1 mg/L increasing（P 0.001） after adjusted for histories of hypertension and diabetes,glucose and lipid.OR（95%CI） of hs-CRP elevation（≥3 mg/L） and HS was 6.599（3.141～13.867） after adjusted for confounding factors（P 0.001）.Further stratification analysis by sex showed that men and women presented different associations of hs-CRP elevation and HS,and the ORs（95%CI） were 8.675（3.206～23.469） and 3.836（1.106～13.308） respectively.Conclusion：Our finding indicated that plasma hs-CRP elevation was significantly associated with increased risk of HS and the association was different between male and female.