hs-CRP持续升高与进展性脑梗死的关系研究

Correlation study between sustained increase of hs-CRP and progressive cerebral infarction

目的探讨超敏C-反应蛋白(hs-CRP)持续升高与进展性脑梗死的关系。方法选取2014年1月-2016年3月贵州省黔西南州人民医院收治的136例急性脑梗死患者作为研究对象,根据其入院时、发病48和72 h后的hs-CRP水平分为持续升高组和非持续升高组,并根据是否发生进展性脑梗死分为进展组和非进展组,比较各组的基线资料、临床指标、入院时的美国国立卫生院神经功能缺损评分(NHISS)、发热、颈动脉狭窄等临床资料。采用Logistics回归分析,筛选出患者出现hs-CRP持续升高及进展性脑梗死的影响因素。结果全部患者中,36.8%(50/136)出现进展性脑梗死,34.6%(47/136)出现hs-CRP持续升高。进展组患者hs-CRP持续升高的发生率为54.0%(27/50),高于非进展组的23.3%(20/86)(P<0.05)。多因素Logistic回归分析结果表明,糖尿病史、三酰甘油、血白细胞计数是患者出现hs-CRP持续升高的影响因素(P<0.05)。空腹血糖、入院时的NHISS评分、发热、hs-CRP持续升高是患者出现进展性脑梗死的影响因素(P<0.05)。结论进展性脑梗死与hs-CRP持续升高有关,进展性脑梗死患者的血清hs-CRP水平升高。

Objective To investigate the correlation between sustained increase of hypersensitive C-reactive protein （hs-CRP） and progressive cerebral infarction. Methods A total of 136 patients with acute cerebral infarction from January 2014 to March 2016 were enrolled for the study and divided into sustained increase group and non-sustained increase group according to the level of hs-CRP at admission, 48 and 72 hours after onset. And they were divided into progressive group and non-progressive group according to whether progressive cerebral infarction occurred. Baseline data, clinical indicators, National Institute of Health Stroke Scale （NIHSS） score at admission, fever and carotid artery stenosis were compared among the groups. Multivariate logistic regression analysis was performed to screen out the factors related to hs-CRP sustained growth and progressive cerebral infarction. Results In all patients, progressive cerebral infarction occurred in 50 cases （36.8%） and hs-CRP sustained growth occurred in 47 cases （34.6%）. The incidence of hs-CRP sustained growth in the progressive group was 54.0% （27/50）, which was significantly higher than 23.3% （20/86） in the non-progressive group （P 〈 0.05）. Multivariate logistic regression analysis showed that the history of diabetes, triglyceride （TG） and blood WBC count were the influencing factors for hs-CRP sustained growth （P 〈 0.05）. Fasting plasma glucose, NHISS score, fever and sustained growth of hs-CRP were the influencing factors for progressive cerebral infarction （P 〈 0.05）. Conclusions Progressive cerebral infarction is related to sustained increase of hs-CRP. The serum level of hs-CRP is signifcantly increased in the patients with progressive cerebral infarction.