血清超敏C反应蛋白和同型半胱氨酸与缺血性脑卒中的相关性

Correlation among serum high sensitive C reactive protein,homocysteine and ischemic stroke

目的:探讨缺血性脑卒中患者血清超敏C反应蛋白(hsCRP)和同型半胱氨酸(Hcy)水平与缺血性脑卒中病情严重程度的相关性。方法:选择131例缺血性脑卒中患者(脑卒中组),根据神经功能缺损程度评分标准分为轻型组59例、中型组41例和重型组31例;根据梗死面积分为腔隙性脑梗死组(55例)、小梗死组(46例)和大梗死组(30例)。另选择同期健康体检者(98例,健康对照组),检测所有研究对象血清hsCRP、Hcy水平,并分析其与缺血性脑卒中患者临床神经功能缺损程度及梗死面积的相关性。结果:缺血性脑卒中患者血清hsCRP、Hcy水平明显高于健康对照组(P均=0.001);与轻型组比较,中型组和重型组hsCRP[(4.43±0.42)mg/L比(6.78±1.48)mg/L比(9.52±1.73)mg/L]、Hcy[(17.49±1.32)μmol/L比(22.18±1.83)μmol/L比(26.01±2.37)μmol/L]水平明显升高,且重型组hsCRP、Hcy水平明显高于中型组(P均=0.001);与腔隙性脑梗死组比较,小梗死组和大梗死组hsCRP[(4.13±0.53)mg/L比(7.61±1.47)mg/L比(9.49±2.18)mg/L]、Hcy[(18.49±3.27)μmol/L比(22.53±4.28)μmol/L比(27.38±5.12)μmol/L]水平明显升高,且大梗死组hsCRP、Hcy水平明显高于小梗死组(P均=0.001),Pearson相关分析显示,缺血性脑卒中患者hsCRP、Hcy水平与临床神经功能缺损程度评分、梗死面积均呈明显正相关(r=0.253~0.641,P均<0.01)。结论:血清超敏C反应蛋白、同型半胱氨酸水平是评估缺血性脑卒中患者病情严重程度的重要指标。

Objective：To explore correlation among serum levels of high sensitive C reactive protein（hsCRP）,homocysteine（Hcy）and severity of ischemic stroke in patients with ischemic stroke.Methods：A total of 131 patients with ischemic stroke were enrolled as stroke group.According to neurologic impairment score,they were divided into mild group（n=59）,medium group（n=41）and severe group（n=31）;according to infarct size,they were divided into lacunar infarction group（n=55）,small infarction group（n=46）and large infarction group（n=30）.Another 98 healthy subjects undergoing physical examination during the same period were selected as healthy control group.Serum levels of hsCRP and Hcy were measured in all groups,and their correlation with clinic neurologic impairment degree and infarct size in patients with ischemic stroke were analyzed.Results：Compared with healthy control group,there were significant rise in serum levels of hsCRP and Hcy in stroke group,P=0.001 both.Compared with mild group,there were significant rise in serum levels of hsCRP [（4.43±0.42）mg/L vs.（6.78±1.48）mg/L vs.（9.52±1.73）mg/L]and Hcy[（17.49±1.32）μmol/L vs.（22.18±1.83）μmol/L vs.（26.01±2.37）μmol/L]in medium group and severe group,and those of severe group were significantly higher than those of medium group,P=0.001 all;compared with lacunar infarction group,there were significant rise in serum levels of hsCRP [（4.13±0.53）mg/L vs.（7.61±1.47）mg/L vs.（9.49±2.18）mg/L]and Hcy[（18.49±3.27）μmol/L vs.（22.53±4.28）μmol/L vs.（27.38±5.12）μmol/L]in small infarction group and large infarction group,and those of large infarction group were significantly higher than those of small infarction group（P=0.001 all）.Pearson correlation analysis indicated that serum serum levels of hsCRP and Hcy were significant positively correlated with clinic neurologic impairment score and infarct size in patients with ischemic stroke（r=0.253-0.641,P〈0.01 all）.Conclusion：Serum levels of hsCRP and Hcy are important indexes assessing severity of ischemic stroke.