老年急性缺血性脑卒中患者颈动脉斑块稳定性和血清hs-CRP水平与近期预后的关系

Relationship between carotid artery plaque stability,serum hs-CRP levels and the recent prognosis of the elderly patients with acute cerebral ischemic stroke

目的观察和分析老年急性缺血性脑卒中(AIS)患者颈动脉斑块稳定性和血清高敏C反应蛋白(hs-CRP)水平与近期预后的关系。方法选取245例老年AIS患者为研究对象,根据预后情况将其分成预后良好组165例和预后不良组80例,对所有患者入院时的颈动脉斑块发生情况及稳定性和入院72h、第1周末、第2末的血清hs-CRP水平进行检测和分析。结果预后良好组和预后不良组患者发生颈动脉斑块的比例分别为77.6%和92.5%,预后不良组显著高于预后良好组(P<0.05);在2组发生颈动脉斑块的患者中,发生不稳定性斑块的患者比例分别为56.2%和77%,预后不良组显著高于预后良好组(P<0.05);2组血清hs-CRP水平比较均有显著差异(P<0.05),预后不良组血清hs-CRP水平显著高于预后良好组。结论颈动脉硬化斑块及其稳定性和血清hs-CRP水平均为与AIS预后相关的因素,临床应根据危险因素制定切实有效的治疗方案,改善患者预后。

Objective To observe and analyze the relationship between carotid artery plaque stability ,serum high sensitivi-ty C reactive protein （hs-CRP） levels and the recent prognosis of the elderly patients with acute cerebral ischemic stroke （AIS）.Methods Totally 245 cases of elderly AIS patients were selected as the research subjects and divided into the good prognosis group and the poor prognosis group according to their prognosis.One hundred and Forty-five patients were included into the good prognosis group ,while 80 patients were included into the poor prognosis group.The situation and stability of the carotid artery plaque of all the patients on admission day ,the hs-CRP levels at the 72nd hour after admission ,on the first and the sec-ond weekend were detected and analyzed. Results The occurrence rates of carotid artery plaque of the patients in the good prognosis group and the poor prognosis group were 77.6% and 92.5% ,respectively ,the incidence of the poor prognosis group was significantly higher than that of the good prognosis group （P〈0.05）;In the patients of the two group with carotid artery plaques ,the incidences with instability plaques were respectively 56.2% and 77% ,the incidence of the poor prognosis group was significantly higher than that of the good prognosis group （P〈0.05）;The differences of the serum hs-CRP levels between the groups ,within each group ,the interactions of between and within the groups were significant （P〈0.05） ,the serum level of hs-CRP in the poor prognosis group was significantly higher than that of the good prognosis group.Conclusion Carotid ath-erosclerosis plaques and serum hs-CRP levels are the factors associated with the prognosis of AIS. The clinicians should apply the effective treatment plan according to the risk factors and improve the prognosis of patients.