超敏C反应蛋白对急性非致残性缺血性卒中早期复发风险的相关性及预测价值研究

Correlation and predictive value of high-sensitivity C-reactive protein for early recurrence of acute non-disabling ischemic cerebrovascular

目的探讨超敏C反应蛋白(hs-CRP)与急性非致残性缺血性卒中(NICE)早期复发风险的相关性及预测价值。方法选取发病72 h内的TIA或轻型缺血性卒中患者126例,记录其发病时一般临床资料和hs-CRP水平,随访30 d。采用Cox回归单因素及多因素分析分别探讨hs-CRP水平与NICE早期复发的相关性,并用ROC分析hs-CRP对NICE复发的预测价值。结果单因素分析显示,与hs-CRP低风险组(<1.0 mg/L)相比,中等风险组(1.0-3.0 mg/L)复发风险为其1.181倍(95%CI:0.456-3.061),高风险组(≥3.0 mg/L)为其4.238倍(95%CI:1.667-10.706)。调整混杂因素后,与低风险组相比,中等风险组复发风险为其1.080倍(95%CI:0.403-2.894),高风险组为其4.776倍(95%CI:1.561-14.615)。hs-CRP水平与NICE复发风险呈正相关(P<0.05)。hs-CRP、ABCD2评分、hs-CRP联合ABCD2评分预测NICE复发的曲线下面积(AUC)分别为0.650(95%CI:0.520-0.780)、0.696(95%CI:0.575-0.817)、0.739(95%CI:0.620-0.859),联合预测的AUC值最大。结论 hs-CRP是NICE复发的预测因子,与ABCD2评分结合后能改善对NICE早期复发的预测能力。

Objective To investigate the correlation and predictive value of high-sensitivity C-reactive protein(hs-CRP) and the risk of early recurrence of acute non-disabling ischemic cerebrovascular events(NICE).Methods One hundred and twenty-six patients with TIA or minor ischemic stroke within 72 h of onset were enrolled. General data and hs-CRP levels were recorded at the onset, and the follow-up time was 30 d. Cox regression univariate and multivariate analysis were used to investigate the correlation between hs-CRP levels and early recurrence of NICE, and ROC was used to analyze the predictive value of hs-CRP for NICE recurrence.Results Univariate analysis showed that compared with that in hs-CRP low-risk group(<1.0 mg/L), the risk of recurrence in the moderate risk group(1.0-3.0 mg/L) was 1.181(95%CI:0.456-3.061), the high-risk group(≥3.0 mg/L) was 4.238(95%CI:1.667-10.706). After adjusting for confounding factors, compared with that in low risk group, the risk of recurrence was 1.080(95%CI:0.403-2.894) in the moderate risk group and 4.776(95%CI:1.561-14.615) in the high risk group. There was a positive correlation between hs-CRP and the risk of NICE recurrence(P<0.05). The area under curve(AUC) of NICE recurrence predicted by hs-CRP, ABCD2, hs-CRP combined with ABCD2 scores were 0.650(95%CI:0.520-0.780), 0.696(95%CI:0.575-0.817) and 0.739(95%CI:0.620-0.859). The combined method got the highest score.Conclusion hs-CRP is a predictor for NICE recurrence, which can improve the predictive ability for early recurrence of NICE combining with the ABCD2 score.