入院血清C反应蛋白与急性缺血性脑卒中患者近期预后的相关性

Impact of Admission Serum C- Reactive Protein on Short Term Outcome in Patients with Acute Ischaemic Stroke

目的探讨入院血清C反应蛋白（CRP）与急性缺血性脑卒中患者短期预后的相关性。方法连续收集2013-01-2014-06间在我院住院诊断为急性缺血性脑卒中80例患者（卒中组）和对照组40例患者的临床资料。测量其入院血CRP水平,并随访患者30 d;研究主要终点30 d格拉斯哥预后评分和改良功能障碍量表的差异。结果卒中组CRP平均值显著高于对照组（P〈0.001）。卒中组和对照组CRP升高的发生率分别为76.3%（n=61）和5.0%（n=2）（P〈0.001）。高CRP水平的卒中组患者死亡率（32.8%）显著高于正常CRP患者（0）（P=0.015）。同时,高入院CRP水平与高死亡率明显相关（P〈0.001）。与预后良好患者相比相比,预后较差患者平均CRP水平明显更高（P〈0.001）。多元回归分析显示,只有高卒中量表（NIHSS）评分（P=0.004）和高入院CRP水平（P=0.008）与短期死亡率独立相关。结论入院高CRP水平和高NIHSS评分是急性缺血性脑卒中患者短期死亡和运动功能不良预后的独立危险因素。

Objective To explore the admission serum C- reactive protein（ CRP） on short term outcome in patients with acute ischaemic stroke. Methods Consecutively selecting 80 patients with acute ischaemic stroke from January,2013 and June,2014 as the apoplexy group,and 40 patients as the control group. Serum CRP was determined on samples obtained at admission. All stroke patients were followed up for 30 days. Outcome measures were the differences between 30 days Glasgow outcome scale score and functional impairment on the modified Rankin Scale. Results Average CRP in the apoplexy was significantly higher than the control group（ P〈0. 001）. The frequency of elevated CRP was 76. 3%（ n = 61） and 5. 0%（ n = 2）（ P〈0. 001） respectively. The case fatality rate in stroke with elevated CRP（ 32. 8%） was significantly higher than stroke with normal admission CRP（ 0）（ P = 0. 015）. The association of higher admission CRP with fatality was statistically significant（ P〈0. 001）. Among survivors,mean CRP levels were markedly higher in the patients with unfavorable motor outcome compared with those with favorable outcome（ P〈0. 001）. In multivariate regression analysis,only high NIHSS score（ P = 0. 004） and admission CRP（ P = 0. 008） were independently associated with case fatality. Conclusion Elevated admission CRP and high NIHSS score are independent predictors of short- term case fatality and motor function poor prognosis.