超敏C反应蛋白、同型半胱氨酸在急性脑梗死患者血清中的水平及其与颈动脉狭窄的相关性研究

Relationship between serum level of C reactive protein,homocysteine and carotid stenosis in patients with acute cerebral infarction

目的观察超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)在急性脑梗死(ACI)患者血清中的水平,并探讨其与颈动脉狭窄(CAS)的相关性。方法 132例ACI合并CAS患者,根据颈动脉狭窄程度分为,轻度狭窄组(n=47例)、中度狭窄组(n=44例)和重度狭窄组(n=41例);根据临床神经功能缺损程度评分标准分为轻型(n=40例)、中型(n=45例)和重型(n=47例);根据脑梗死病灶面积分为腔隙性梗死组(n=42例)、小面积梗死组(n=46例)和大面积梗死组(n=44例);根据斑块性质分为分为软斑组(n=43例)、硬斑组(n=43例)和其他类型组(n=46例)。比较各组血清hs-CRP、Hcy表达水平。结果各狭窄组ACI患者血清hs-CRP、Hcy表达水平均明显高于对照组(P<0.05),且随着颈动脉狭窄程度加重,血清hs-CRP、Hcy表达水平显著性升高(P<0.05);不同病情程度组ACI患者血清hs-CRP、Hcy表达水平均明显高于对照组(P<0.05),且随着病情程度加重,血清hs-CRP、Hcy表达水平显著性升高(P<0.05);不同病灶面积组ACI患者血清hs-CRP、Hcy表达水平均明显高于对照组(P<0.05),且随着病灶面积增大,血清hs-CRP、Hcy表达水平显著性升高(P<0.05);不同斑块性质组ACI患者血清hs-CRP、Hcy表达水平均明显高于对照组(P<0.05),且随着斑块性质逐渐加重,血清hs-CRP、Hcy表达水平均明显升高(P<0.05)。结论血清Hcy、hs-CRP表达水平随CAS程度、病情程度、病灶面积及斑块性质加重而升高,可作为判断ACI患者病情严重程度的实验室指标。

Objective To investigate the expression of C reactive protein （hs-CRP）, homocysteine （Hcy） in the serum of patients with acute cerebral infarction （ACI）, and discuss the relationship between hs-CRP, Hcy and carotid stenosis （CAS）. Methods 132 patients with ACI and CAS were divided into mild stenosis group （47 cases） , moderate stenosis group （n=44 cases） and severe stenosis group （n=41 cases） according to the degree of carotid stenosis, divided into light （ n = 40 cases）, medium （ n = 47 cases） and heavy （ n = 45 cases） according to the clinical neural function defect degree score standards, divided into lacunar infarction group （n = 42 cases） , small area infarction group （n = 46 cases） and large area infarction group （n = 44 cases） according to cerebral infarction lesion area, divided into soft plaque group （n = 43 cases）, hard plaque group （n = 43 cases） and other types group （n=46 cases） according to patch character. The expression levels of serum hs-CRP, Hcy in all groups of ACI patients were compared. Results The expression levels of serum hs-CRP, Hcy in all stenosis groups of patients with ACI were significantly higher than that of the control group（P〈0.05） ,and with the degree of carotid artery stenosis increased, the expression levels of serum hs-CRP and Hcy increased significantly（P〈0.05）. The expression level of serum hs-CRP, Hcy in different severity groups of patients with ACI were significantly higher than that of the control group （P〈0.05）, and with the aggravation of the severity of disease increased, the expression levels of serum hs-CRP and Hcy increased significantly（ P〈0.05 ）.The expression levels of serum Hcy and ACI in different lesion area groups of patients with ACI were significantly higher than that of the control group （P〈0.05）, and with the lesion area increased, the expression levels of serum hs-CRP and Hcy increased significantly（P〈0.05）.The expression levels of serum Hcy and ACI in different patch properties groups of patients with ACI were significantly higher than that of the control group （P〈0.05）, and with the with the gradual increase of the patch properties, the expression levels of serum hs-CRP and Hcy increased significantly （P 〈 0. 05 ）. Conclusion The serum levels of Hcy and hs-CRP increased with the increase of CAS level, degree of illness, lesion size and the patch properties. It can be used as a laboratory index to judge the severity of ACI.