脑梗死溶栓前超敏C反应蛋白、脂联素、脂蛋白相关磷脂酶A2与溶栓后早期转归及预后的关系

The association of high-sensitivity C-reactive protein,adiponectin and lipoprotein-associated phospholipase A2 before thrombolysis with early outcomes and prognosis after thrombolysis for cerebral infarction

目的探讨脑梗死溶栓前超敏C反应蛋白(hs-CRP)、脂联素(APN)、脂蛋白相关磷脂酶A2(Lp-PLA2)与溶栓后早期转归及预后的关系。方法我院收治的80例急性脑梗死患者,治疗前检测hs-CRP、APN、Lp-PLA2水平,记录溶栓前后神经功能缺损评分(NIHSS),将NIHSS评分作为早期转归评估指标,≥4分、1~3分、≤0分为显效、有效、无效,对比不同早期转归患者hs-CRP、APN、Lp-PLA2水平。在溶栓后7 d以改良Rankin评分(mRS)评估患者预后,≤2分、3~4分、5~6分为预后良好、预后一般、预后不良,对比不同预后患者hs-CRP、APN、Lp-PLA2水平。分析hs-CRP、APN、Lp-PLA2水平与NIHSS评分和mRS评分的相关性。结果hs-CRP、Lp-PLA2水平比较,显效组<有效组<无效组,预后良好组<预后一般组<预后不良组;APN水平比较,显效组>有效组>无效组,预后良好组>预后一般组>预后不良组(P<0.05)。hs-CRP、Lp-PLA2水平与△NIHSS评分呈负相关,与mRS评分呈正相关;APN水平与△NIHSS评分呈正相关,与mRS评分呈负相关(P<0.05)。结论脑梗死患者溶栓前hs-CRP、APN、Lp-PLA2水平与溶栓后早期转归及预后存在相关性,可帮助评估患者早期转归及预后情况。

Objective To investigate the associationof high-sensitivity C-reactive protein(hs-CRP),adiponectin(APN)and lipoprotein-associated phospholipase A2(Lp-PLA2)before thrombolysis for cerebral infarctionwith early outcomes and prognosis after thrombolysis.Methods Eighty patients with acute cerebral infarction were enrolled.The levels of hs-CRP,APN and Lp-PLA2 were detected before treatment.The scores of National Institutes of Health Stroke Scale(NIHSS)before and after thrombolysis were recorded.Taking NIHSS score as the evaluation index of early outcomes,NIHSS score≥4,1~3 and≤0 were defined as markedly effective,effectiveand ineffective,respectively.The levels of hs-CRP,APN and Lp-PLA2 in patients with different early outcomes were compared.After 7 daysof thrombolysis,the prognosis was evaluated with modified Rankin scale(m RS)score.The Mrs Scores≤2,3~4 and 5~6 were defined as good prognosis,general prognosis and poor prognosis,respectively.The levels of hs-CRP,APN and Lp-PLA2 in patients with different prognosis were compared.The correlation between hs-CRP,APN,Lp-PLA2 levels and NIHSS scoreas well as Mrs Score was analyzed.Results The levels of hs-CRP and Lp-PLA2 were increased in sequencein the markedlyineffective group,effective group and the effective group as well as in the good prognosis group,general prognosis group and poor prognosis group(P<0.05)while the order of APN level was on the contrary(P<0.05).The hs-CRP and Lp-PLA2 levels were negatively correlated with NIHSS score and positively correlated with Mrs Score(P<0.05)while APN level was positively correlated with NIHSS score and negatively correlated with Mrs Score(P<0.05).Conclusion The levels of hs-CRP,APN and Lp-PLA2 before thrombolysis are correlated with the early outcomes and prognosis ofpatients with cerebral infarctionafter thrombolysis.These can helpevaluate early outcome and prognosis.