急性缺血性脑梗死患者缺血修饰清蛋白、超敏C反应蛋白水平及其对预后的价值研究

Expression of Ischemia- modified Albumin and High Sensitivity C Reactive Protein of Patient With Acute Ischemic Stroke and Their Value for Prognosis

目的观察急性缺血性脑梗死(AIS)患者血清缺血修饰清蛋白(IMA)、超敏C反应蛋白(hs-CRP)水平,并探讨二者对AIS预后的价值。方法选取2015年2月—2016年1月湖北民族学院附属民大医院神经科确诊的AIS患者77例为AIS组,及同期在本院进行健康体检的健康人群65例为对照组。根据《脑卒中的分型分期治疗(建议草案)》将AIS患者的不同时期定义为急性期(n=77)和恢复期(n=77),比较AIS组不同时期及对照组IMA、hs-CRP水平。根据美国国立卫生研究院卒中量表(NIHSS)将AIS患者分为中(n=31)、重度组(n=46),比较不同神经损伤患者IMA、hs-CRP水平。同时,对IMA水平与hs-CRP水平以及二者与NIHSS评分的相关性进行Pearson相关性分析。结果 AIS组不同时期及对照组IMA、hs-CRP水平间差异均有统计学意义(P<0.05);其中AIS组急性期、恢复期均高于对照组,差异有统计学意义(P<0.05);AIS组急性期均高于恢复期,差异亦有统计学意义(P<0.05)。在急性期、恢复期AIS组患者IMA水平与hs-CRP水平均呈线性正相关(r值分别为0.42、0.48,P<0.05)。重度组患者IMA、hs-CRP水平均高于中度组,差异有统计学意义(P<0.05)。IMA、hs-CRP水平与NIHSS评分均呈线性正相关(r值分别为0.58、0.42,P<0.01)。结论 AIS患者IMA、hs-CRP水平均升高,二者有明显的相关性,且均与NIHSS评分有关。因此,推测联合检测IMA、hs-CRP水平可能对AIS早期诊断、判断预后及指导治疗具有重要价值。

Objective To investigate the expression of ischaemia- modified albumin（ IMA） and high sensitive C-reactive protein（ hs-CRP） in patients with acute ischemic stroke（ AIS） and explore their value for the prognosis of AIS. Methods We enrolled 77 patients who were definitely diagnosed with AIS in the department of neurology in Minda Hospital Affiliated to Hubei University for Nationalities from February 2015 to January 2016 as AIS group,and enrolled 65 healthy people who received physical examination in the hospital in the same period as controls. According to Treatment for Stroke by Classification and Staging（ recommended draft）,we defined AIS patients at differernt times as acute stage（ n = 77） and recovery stage（ n = 77）.Expression of IMA and hs-CRP was compared among AIS patients at different stages and controls. According to NIHSS, the patients were divided into moderate group（ n = 31） and severe group（ n = 46）,and the levels of IMA and hs-CRP of patients with different nerve injury degrees were compared. Meanwhile, Pearson correlation analysis was conducted to investigate the correlation between the levels of IMA and hs-CRP and their correlation with NIHSS score. Results AIS patients at different stages and controls were significantly different in the levels of IMA and hs-CRP（ P〈0. 05）; AIS patients at acute stage and recovery stage were higher than controls（ P〈0. 05）,and AIS patients at acute stage were higher than AIS patients at recovery stage（ P〈0. 05）. There was positive linear correlation between IMA level and hs-CRP level in AIS patients at acute stage and recovery stage（ r value was 0. 42 and 0. 48 respectively,P〈0. 05）. Severe AIS patients were higher than moderate AIS patients in the levels of IMA and hs-CRP（ P〈0. 05）. Levels of IMA and hs-CRP were positively linearly correlated with NIHSS score（ r value was 0. 58 and 0. 42 respectively, P〈0. 01）. Conclusion AIS patients have higher IMA and hs-CRP levels, and there is correlation between the levels of IMA and hs-CRP and correlation between IMA and hs-CRP levels and NIHSS score. Therefore,the combined detection of IMA and hs-CRP levels may have significant value for the early diagnosis of AIS, prognosis and guidance on the treatment.