缺血性脑卒中急性期血清肌钙蛋白I升高的临床意义

Clinical significance of increased serum cTnI in patients with acute ischemic stroke

目的 探讨血清c Tn I水平变化在急性缺血性脑卒中患者的临床意义。方法 回顾性分析90例急性缺血脑卒中患者临床资料。根据c Tn I水平分为c Tn I正常组和c Tn I增高组,分析2组患者心电图改变和急性期死亡率的差异,以及2组患者随访期间心脑血管严重不良事件发生情况。结果 急性缺血性脑卒中患者血清c Tn I水平与NIHSS评分呈显著正相关（r=0.504,P〈0.01）;c Tn I增高组急性期死亡率（Fisher＇s精确概率检验：P=0.041）高于c Tn I正常组。Cox回归分析表明c Tn I增高组较正常组发生严重心脑血管不良事件的风险显著增加（RR=2.759,95%CI：1.171~6.500,P=0.020）。结论 急性缺血性脑卒中患者血清c Tn I水平与卒中严重程度呈正相关,c Tn I水平增高提示预后不良。

Objective To explore the clinical significance of increased serum cardiac troponin I（ c Tn I） in patients with acute ischemic stroke. Methods Clinical materials of 90 patients with acute ischemic stroke were analyzed retrospectively,and they were divided into normal c Tn I group and increased c Tn I group according to their serum c Tn I. Change of electrocardiogram and mortality in the acute phase were compared between two groups,and the incidence of cerebro- / cardio- vascular events in the follow- up period was also compared. Results The level of serum c Tn I was positively correlated with the NIHSS score in the acute phage of stroke. The mortality in the increased c Tn I group was significantly higher than that in the normal c Tn I group（ Fisher＇s exact test： P = 0. 041）. Cox regression analysis also suggested that patients in the c Tn I- increased group had a higher risk of cerebro- / cardio- vascular adverse events in the follow- up period（ RR = 2. 759,95% CI 1. 171- 6. 500,P = 0. 020）. Conclusion Serum c Tn I level is positively correlated with severity of stroke in patients with acute ischemic stroke,and c Tn I level can indicate a poor prognosis.