影响老年急性脑梗死病人神经功能缺损程度的相关因素分析

Analysis of the ralated factors affecting the degree of neurological impairment in elderly patients with acute cerebral infarction

目的探讨老年急性脑梗死病人血清hs-CRP、TNF-α、IL-6、Hcy、D-二聚体(D-dimer)的水平与神经功能缺损程度的相关性。方法选取2015~2018年我院收治的160例急性脑梗死病人作为病例组,依据NIHSS评分将入院病人依次分为低评分组65例、中评分组49例、高评分组46例。另选取同期于我院行健康体检的160例健康志愿者作为对照组。检测各组hs-CRP、TNF-α、IL-6、Hcy、D-dimer的水平,并分析上述指标与NIHSS评分的相关性。结果病例组的hs-CRP、TNF-α、IL-6、Hcy、D-dimer水平均高于对照组,差异有统计学意义(P<0.01)。高评分组的hs-CRP、TNF-α、IL-6、Hcy、D-dimer水平均高于中评分组与低评分组,中评分组上述指标水平均高于低评分组,差异有统计学意义(P<0.01)。hs-CRP、TNF-α、IL-6、Hcy、D-dimer的水平与NIHSS评分均呈正相关(r=0.426、0.734、0.478、0.593、0.452,P<0.05)。结论hs-CRP、TNF-α、IL-6、Hcy、D-dimer在老年急性脑梗死病人中异常升高,且均是加剧神经功能缺损严重程度的相关因素。

Objective To explore the correlation between the levels of high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),homocysteine(Hcy),D-dimer and the degree of neurological impairment in the elderly patients with acute cerebral infarction.Methods A total of 160 patients with acute cerebral infarction admitted to our hospital from January 2015 to December 2018 were enrolled as the case group.According to NIHSS score,they were divided into low-score group with 65 cases,middle-score group with 49 cases and high-score group with 46 cases.Another 160 healthy elderly volunteers who underwent physical examination in our hospital during the same period were selected as the control group.The levels of hs-CRP,TNF-α,IL-6,Hcy and D-dimer were measured in each group,and the correlation between the above indexes and NIHSS score was analyzed.Results The levels of hs-CRP,TNF-α,IL-6,Hcy and D-dimer in the case group were significantly higher than those in the control group(P<0.01).The levels of hs-CRP,TNF-α,IL-6,Hcy and D-dimer in the high-score group were higher than those in the middle-score group and the low-score group,and the levels of the above indexes in the middle-score group were higher than those in the low-score group(P<0.01).The levels of hs-CRP,TNF-α,IL-6,Hcy and D-dimer were positively correlated with NIHSS scores(P<0.05).Conclusions The levels of hs-CRP,TNF-α,IL-6,Hcy and D-dimer are abnormally increased in the elderly patients with acute cerebral infarction,and they are related factors of the severity of neurological impairment.