超敏C反应蛋白与急性脑梗死及中国缺血性卒中亚型的关系

Relationship between high sensitive C-reactive protein and stroke subtype according to Chinese Ischemic Stroke Subclassification criteria in patients with acute cerebral infarction

回顾分析我院2012年1月至2013年6月收住的216例急性脑梗死（ACI）患者的临床资料。ACI患者血清超敏C反应蛋白（hs-CRP）水平高于186例体检者[（4．29±2．30）与（2．13±1．79）mmoVL，P〈0．01]。美国国立卫生研究院卒中量表（NIHSS）评分〉8分的127例ACI患者血清hs—CRP水平高于NIHSS评分≤8分89例患者[（5．89±4．15）与（2．11±1．45）mg／L，P〈0．05）]；98例大动脉粥样硬化型患者的hs—CRP水平为（6．32±4．12）mv／L，hs．CRP阳性（〉3mg／L）率为85．7％（84／98），均高于穿支小动脉病变型[（1．97±0．86）mg／L，7／71]、心源性栓塞型[（3，70±2．76）mg／L，14／24]、不明病因型[（3．43±3．52）mg／L，5／11]和其他原因明确型[（3．41±3．25）mg／L，5／12]（均P〈0．05）。logistic回归分析高血压病、糖尿病、房颤、吸烟、TC、高同型半胱氨酸及he—CRP与ACI呈正相关（OR值为1．17～3．08，均P〈0．01）。提示ACI患者hs．CRP水平明显增高，且与神经功能缺损程度有关。

By analyzing the clinical data of 216 cases of acute cerebral infarction （ACI） from 2012 January to 2013 June retrospectively, we found that the serum levels of high sensitive C-reactive protein （hs-CRP） in patients were significantly higher than those in 186 controls （P 〈 0.01 ）. The degree of neural function defect in ACI patients was assessed by the National Institutes of Health Stroke Scale （NIHSS） score. The hs-CRP level of the patients with NIHSS score 〉 8 were higher than that in those with NIHSS score ≤8 （ P 〈 0.05）. The hs-CRP level of patients of large artery atherosclerosis were （6.32 ± 4.12） mg/L and the positive rate of hs-CRP was 85.7% （84/98）. All were respectively higher than those in patients of penetrating artery disease [ （ 1.97± 0.86） rag/L, 7/71 ], cardiogenic stroke [ （ 3.70 ± 2.76 ）rag/L, 14/24], undetermined etiology [（3.43 ±3.52） rag/L, 5/11 ] and other etiologies [ （3.41 ±3.25） rag/L, 5/12] （all P 〈0.05 ）. Logistic regression analysis was performed for the risk factors of ACI. The correlative factors of ACI included hypertension, diabetes mellitus, atrial fibrillation, smoking, total cholesterol, homocysteine and high sensitive C-reactive protein （OR = 1.56, 1. 19, 1.23, 1. 17, 3.08, 1.34, 1.25, all P 〈 0.01 ）. The serum levels of hs-CRP increased significantly in ACI patients and were correlated with the degree of neural function defect.