纤维蛋白原、C-反应蛋白与脑梗死分型及病情严重程度的相关性

The relationship between fibrinogen / C-reactive protein and subtypes / severity degree of acute cerebral infarction

目的探讨纤维蛋白原(Fib)、C-反应蛋白(CRP)与脑梗死分型及病情严重程度的相关性。方法 296例24小时内发病的脑梗死患者(病例组),按TOAST方法分为大动脉粥样硬化性脑卒中(LAA)、小动脉闭塞性脑卒中(SAO)、心源性脑栓塞(CE)、其他确定原因引发的缺血性脑卒中(SOE)和不明原因的缺血性脑卒中(SUE)型5个亚型,选取同期健康体检者106例为对照组。病例组在入院24小时内测定Fib、CRP,在入院第1天行NIHSS评估,入院48小时内测定脑梗死体积。分析Fib、CRP与脑梗死分型及病情严重程度的相关性。结果 LAA和CE组的Fib、CRP水平高于其它组(P<0.05);Fib、CRP与入院NIHSS评分、梗死面积呈正相关且与LAA、CE组相关(P<0.05)。结论 Fib、CRP为LAA、CE亚型脑梗死的独立危险因素,与脑梗死的病情严重程度正相关。LAA、CE亚型脑梗死存在较重的炎性反应。

Objective To investigate the relationship between fibrinogen（Fib）, C-reactive protein（CRP） and subtypes and severity degree of acute cerebral infarction. Methods Two hundred and ninety-six patients with acute cerebral infarction within 24 hours （ disease group） were divided into 5 subgroups of large artery atherosclerosis （LAA） stroke, small artery occlusion （ SAO ） stroke, cardio embolism（CE） stroke, other demonstrated etiology（SOE） stroke and undemonstrated etiology（SUE） stroke by using the TOAST classification method. At the same time, 106 healthy subjects were used as control group. The Fib and CRP were measured in the disease group within 24 hours administrated to the hospital. NIHSS scores were evaluated on the days 1 of hospitalization. Volume of cerebral infarction was evaluated within 48 hours of hospitalization. The relationship between fibrinogen（Fib） ,C-reactive protein（CRP） and subtypes/se- verity degree of acute cerebral infarction was analyzed. Results The levels of Fib and CRP levels in patients with subtype LAA and CE group were higher than that in the other subtype groups（ P 〈 0. 05 ）. The levels of Fib and CRP were positively correlated with NIHSS scores and infarct areas, and correlated with the subtypes LAA and CE as well. Conclusion The levels of Fib and CRP levels are independent risk factor for subtypes of LAA and CE and positively associated with severity degree of the disease. There is heavier inflamma- tion in the patients with LAA and CE.