C反应蛋白在缺血性卒中病情以及预后评估中的价值

The value of C reactive protein in condition and prognosis of ischemic stroke

目的探讨C反应蛋白水平(CRP)与初次缺血性卒中的病情的严重程度以及预后的相关性。方法连续性纳入2013年10月-2014年6月在郑州大学附属洛阳中心医院神经内科住院的发病时间≤72 h的首发缺血性卒中患者(CT或核磁共振证实),进行回顾性分析,按发病至入院时间在24 h、48 h、72 h之内将患者分组,进行CRP测定,同时在入院时及住院第10天分别进行NIHSS评分,分析两者的相关性。结果共纳入103例符合标准的缺血性卒中患者。发病24 h、48 h和72 h内入院患者,C反应蛋白水平比较无统计学差异。72 h内所有入院患者,CRP水平与入院时NIHSS评分严重程度正相关(r=0.683,P<0.001);其中CRP≥6 mg/L患者的CRP值与NIHSS评分正相关(r=0.661,P<0.001),而CRP<6 mg/L患者的CRP值与NIHSS评分无相关性(r=-0.117,P=0.322)。72 h内入院患者的CRP值与住院10 d的NIHSS评分相对恢复率呈负相关(r=-0.252,P=0.010);其中经调整的CRP≥6 mg/L患者的CRP值与住院10 d时NIHSS评分相对恢复率呈负相关(r=-0.449,P=0.019)。结论 C反应蛋白可作为缺血性脑卒中发病严重程度以及预后判断的监控指标,是缺血性脑卒中发生、发展以及预后评价的敏感指标。

Objective To investigate the relationship between the levels of C-reactive protein（ CRP） and the condition and prognosis of first ischemic stroke. Methods The patients with first acute ischemic stroke confirmed by computed tomography（ CT） or magnetic resonance imaging（ MRI） were recruited at Department of Neurology,Luoyang Central Hospital from October 2013 to June 2014. The patients were divided into three groups by the time of onset within 24 h,48 h and72 hours. The serum levels of CRP,the NIHSS scores of the first day and the tenth day were measured. Then analyzed the correlation between the CRP and prognosis. Results Total 103 patients were included. In all the cases,CRP levels had no correlation with onset time. Among the patients arrived to hospital by the time of onset within 72 hours,the CRP levels were positively related with the NIHSS scores（ r = 0. 683,P〈 0. 001）. Among them,the CRP≥6 mg / L subgroup showed positive correlation（ r = 0. 661,P〈 0. 001）,but the CRP〈 6 mg / L subgroup had no statistical difference（ r =- 0. 117,P = 0. 322）.The NIHSS score relative recovery of the tenth day had negative correlation with CRP levels of the patients admitted to hospital within 72 hours of symptom onset（ r =- 0. 252,P = 0. 010） and the patients in CRP≥6 mg / L subgroup which had adjusted the outliers（ r =- 0. 449,P = 0. 019）. Conclusions CRP can be used as monitoring indicator of ischemic stroke severity and prognosis. CRP can be considered as a sensitive marker of the occurrence,development and prognosis of ischemic stroke.