急性缺血性脑卒中血浆hs-CRP、HCY及FIB与残余血流动力学分型相关性研究

Correlation between Plasma hs-CRP, HCY and FIB and Residual Hemodynamic Typing in Patients with Acute Ischemic Stroke

目的：探索脑梗死急性期超敏C反应蛋白、同型半胱氨酸及纤维蛋白原血浆标志物与残余血流动力学分型的相关性,血流动力学分型对早期神经功能缺损严重性的预测价值。方法：共有96例患者按入院先后顺序入组。发病后72 h内,入院24 h内采用LX-20全自动生化分析仪,对血浆hs-CRP、HCY进行测定,并行TCD检查,并按统计学方法进行相关性分析。结果：完全闭塞、部分闭塞及非闭塞组间入院时和发病后第7天NIHSS评分具有统计学意义（P〈0.05）,其两两比较,完全闭塞组与部分闭塞组和非闭塞组间有统计学意义（P〈0.05）。血浆hs-CRP、FIB与残余血流分型具有显著性相关（r=-0.29,P=0.008;r=-0.31,P=0.004）,然而HCY无显著性相关（r=-0.17,P=0.07）。3组间hs-CRP和FIB均具有统计学意义（P〈0.05）,而HCY差异无统计学意义（P〉0.05）。结论：根据残余血流动力学分型,可预测完全闭塞较部分闭塞组及非闭塞组早期神经功能缺损严重。急性期血浆hs-CRP、FIB与残余血流动力学分型具有显著性负相关,即高水平的血浆hs-CRP和FIB具有较差的残余血流分型。

Objective：To explore the correlation between plasma high-sensitivity creactive protein（hs-CRP）,homocysteine and fibrinogen（FIB） and residual hemodynamic classification in acute cerebral infarction,and the predictive value of hemodynamic classification for the severity of early neurological deficit. Methods：We prospectively studied 96 inpatients with acute ischemicstroke who were admitted within 72 hours after the onset of symptoms. Plasma hs-CRP and HCY were measured by LX-20 automatic biochemical analyzer within 24 hours after admission, and TCD was performed. Correlation analysis was performed by statistical method. Results：Among complete occlusion,partial occlusion and non-occlusion groups,there was significant difference in the degree of NIHSS score on adimission and 7 days after the onset（P〈0.05）,which the difference was statistically significant on NIHSS score comparing between complete occlusion group and the partial occlusion and non-occlusion groups（P〈0.05）. Significant correlation between plasma hs-CRP,FIB level and residual hemodynamic types（r=-0.29,P=0.008;r=-0.31,P=0.004）was observed. However,there was no significant correlation between plasma HCY level and residual hemodynamic types（r=-0.17,P=0.07）. Among the three groups,there was significant difference in the level of hs-CRP and FIB（P〈0.05）,but there was no significant difference in the level of HCY（P〉0.05）. Conclusion：According to the residual hemodynamic types,it is able to predict early severe neurological deficit of the complete occlusion group compared with the partial occlusion and non-occlusion group. The plasma hs-CRP,FIB level of acute phase is negatively related to the residual hemodynamic types;i.e.,the higher level of plasma hs-CRP and FIB,the poorer residual hemodynamic types.