脑梗死患者血清胆红素、P选择素与C反应蛋白的动态变化及意义

The dynamic changes and clinical significance of serum bilirubin, P-selectin and C-reactive protein in patients with cerebral infarction

目的探讨急性脑梗死患者血清胆红素、P选择素和C反应蛋白在不同时间、不同病情的动态变化及其临床意义。方法脑梗死患者98例,根据神经功能缺损程度将患者分为轻型(38例)、中型(35例)、重型(25例),另外选取30名体格检查正常者为对照组,测定不同时期、病情程度不同患者和对照组健康查体者血清中的可溶性P选择素和血清胆红素及超敏C反应蛋白水平的动态变化。结果急性期(24 h、3 d、7 d)脑梗死患者血清胆红素、P选择素和超敏C反应蛋白水平明显高于对照组,中重型患者P选择素、胆红素和超敏C反应蛋白水平高于轻型患者,有统计学意义(P<0.05)。随时间延长,P选择素、胆红素、超敏C反应蛋白水平逐渐降低;14 d时,脑梗死患者P选择素含量与对照组无统计学意义(P>0.05),超敏C反应蛋白水平与对照组相比有统计学意义(P<0.05)。结论 P选择素和胆红素可能参与脑梗死的病理过程,脑梗死患者时间、病变程度不同,P选择素和胆红素的水平不同,与超敏C反应蛋白呈正相关,测定它们有利于脑梗死的早期诊治及判断预后。

Objective To evaluate and explore the dynamic changes and clinical significance of serum P-selectin and bilirubin in elderly patients with acute cerebral infarction（ACI）. Methods The levels of P-selectin, bilirubin and high sensitivity C-reactive protein were measured in deferent time and degree in 98 patients with cerebral infarction. Severe ACI group（n = 38）, moderate ACI group（n = 35） and mild ACI group（n = 25） according to their nerve function deficiency score, thirty healthy subjects served as a control group. Results Serum P-selectin, bilirubin and high sensitivity C-reactive protein levels（hsCRP） in acute cerebral infarction were higher significantly than those of patients with normal controls in 24 hour, 3 day, 7 day after stroke onset（P〈0.05）. Serum P-selectin and bilirubin levels in patients with moderate and severe patients were higher than that of in mild form patients. Serum P-selectin, bilirubin and hsCRP concentration were decreased with time delay. There were no obviously significance of P-selectin and bilirubin concentration in three groups patients in 14 d（P〉0.05）, but hsCRP were higher significantly than those of patients with normal controls（P〈O.05） in 14 d. Conclusions Serum P-selectin and bilirubin may be involved in the pathological process of ACI. The changes of serum P-selectin and bilirubin levels were contributed to judge severity of pathological changes, focus range and prognosis assessment. degree of P-selectin and bilirubin showing positive correlation with hsCRP, it is an important biochemical observational indicator, and it＇s worthy recommending in clinic.