超敏C反应蛋白预测幕上自发性脑出血早期血肿扩大的临床研究

Clinical study of high-sensitivity C-reactive protein predicting early hematoma growth in spontaneous supratentorial intracerebral hemorrhage

目的 探讨血清超敏C反应蛋白（hs-CRP）的水平对于幕上自发性脑出血早期血肿扩大的预测价值。方法 于入院时及入院24 h对86例急性幕上自发性脑出血患者行头颅CT,根据有无早期血肿扩大将患者分为早期血肿扩大组及血肿稳定组。采用免疫透射比浊法检测患者的血清hs-CRP水平。结果 根据有无早期血肿扩大将患者分为早期血肿扩大组22例及血肿稳定组64例。早期血肿扩大组[（52.75±27.59）mg/L]的血清hs-CRP水平明显高于血肿稳定组[（19.69±11.56）mg/L]（P〈0.01）。经Spearman相关分析显示,血清hs-CRP水平与早期血肿扩大呈正相关（r=0.544,P〈0.01）。早期血肿扩大的ROC曲线下面积为0.860（95%CI：0.752-0.968,P〈0.0001）。Youden指数显示,敏感性和特异性分别为91%和58%,hs-CRP16.65 mg/L为最佳。结论 血清hs-CRP水平可以预测幕上自发性脑出血早期血肿扩大,16.65 mg/L为最佳,且敏感性较高。

Objective To investigate the levels of serum high-sensitivity C-reactive protein （hs-CRP） for early hematoma growth （EHG） in spontaneous supratentorial intracerebral hemorrhage on the predictive value. Methods Eighty-six patients with acute spontaneous supratentorial intracerebral hemorrhage underwent the CT scan at and 24 hours after admission： According to the presence of early hematoma growth, the patients were divided into EHG group and stable hematoma group. Serum hs-CRP levels were tested by immune transmission turbidimetry. Results According to the presence of early hematoma growth, 22 cases were in EHG group, 64 cases were in stable hematoma group. The levels of serum hs-CRP in EHG Group [ （52.75 ±27.59）mg/Ll were significantly higher than those in hematoma stable group [ （ 19.69 ± 11.56） mg/L ] （P 〈 0. 01 ）. The Spearman correlation analysis showed that serum hs-CRP levels and EHG were positively correlated （r = 0. 544, P 〈 0. 01 ）. The area under the receiver operating characteristics curve of EHG was 0. 860 （95% CI： O. 752 - 0. 968, P 〈 0. 0001 ）. Youden＇s index showed the predictive sensitivity and specificity for EHG were 91% and 58% respectively, the cutoff value of hs-CRP was 16.65 mg/L. Conclusion Serum hs-CRP level can predict early hematoma enlargement, 16.65 mg/L is the best, and the sensitivity is higher.