老年脑梗死患者血清C反应蛋白水平的动态变化及临床意义  

Dynamic change and clinical significance of the serum C-reactive protein level in elderly cerebral infarction patients

作　　者：于艳春[1] 杨柳[2] 杨文[3] 张艳华[3] 刘柏辉[3] 季有梅[1] 徐丹[1] 许桂英[1] 

机构地区：[1]吉林大学第二医院民康医院,吉林长春130041 [2]长春市中心医院检验科 [3]吉林大学第二医院综合内科

出　　处：《中国实验诊断学》2007年第8期1046-1049,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨老年脑梗死患者血清C-反应蛋白(CRP)水平的动态变化与病情严重程度和预后的关系。方法用免疫比浊法测定106例入选对象入院第1、3、7、14、28天的CRP水平,同时选择年龄、性别相似的健康老年人40例为对照组。根据脑卒中患者临床神经功能缺损程度评分标准(NDS),对老年脑梗死患者进行评分。患者均进行CT/MRI扫描确诊。结果(1)老年脑梗死组CRP水平较对照组明显升高(P<0.05)。老年脑梗死患者CRP水平于第3天升高最显著(18.67±3.72 mg/L),之后逐渐下降,于第28天降至较低水平(7.65±1.64 mg/L),但仍高于对照组(2.17±0.86 mg/L)(P<0.05)。(2)老年脑梗死患者CRP水平为重型>中型>轻型组(P<0.05)。轻型组于第28天基本恢复正常(2.39±0.64mg/L),而重型组仍保持较高水平(10.85±3.16 mg/L)(P<0.05)。(3)老年脑梗死患者CRP水平呈大梗死灶>小梗死灶>腔隙性梗死(P<0.05或P<0.01)。CRP水平在腔隙性梗死于第28天接近正常(2.47±0.68 mg/L),而大梗死灶即使在恢复期仍明显高于腔隙性梗死组(13.38±3.87 mg/L)(P<0.05)。(4)老年脑梗死患者的预后与CRP异常率有关,预后差的患者CRP阳性率(79.17%)明显高于预后好转组(39.02%)(P<0.01);CRP阳性患者的死亡率(31.37%)显著高于阴性者(3.64%)(P<0.01)。结论老年脑梗死与CRP水平关系密切。CRP水平越高,则病情越重、预后越差、死亡率越高。CRP可作为老年脑梗死的危险预测因子,还是一个判断病情严重程度和预后的客观指标。Objective To investigate dynamic change and clinical significance of the serum C-reactive protein（CRP） level in elderly cerebral infarction patients. Methods 106 elderly patients and 40 healthy elderly persons as control were enrolled in this study. The serum CRP levels on the lst,3rd 7th, 14th,28th day after admission were determined with immunoturbidimetry. All the patients were finally diagnosed by cr and MRI and scored by clinic nerological function deficit scale （NDS）. Results （ 1 ） Compared with control group, the serum CRP level in elderly acute cerebral infarction group increased significantly（P 〈 0.05 ） .That on the 3rd day was the highest[ （ 18.67 ± 3.72） me/L] then gradually decreased to lower level [ （7.65 ±1.64） mg/L] on the 28th day, but was higher than that in control group [ （2.17 ±0.86） mg/L] （ P 〈 0.05）. （2） The serum CRP level increased in order according to different degrees of elderly cerebral infarction（ P 〈 0.05）. On the 28th day, in light degree group, the CRP level returnd to normal level [ （2.39 ± 0.64） mg/L] ; but that in severe group remained higher[ （ 10.85 ± 3.16） mg/L] （ P 〈 0.05 ） （3） The serum CRP level increased in order according to different infarction areas（ P 〈 0.05 or P 〈 0.01）. On the 28th day, in lacunar infarction group, the CRP level retumd to normal level[ （2.47 ± 0.68）mg/L] ;but even though at restoration stage, that in large infarction focus group remained higher than that in lacunar infarction group[ （ 13.38± 3.87） mg/L] （ p 〈 0. 05）. （4） qhe prognosis of elderly cerebral infarction patients was correlated to the CRP level, The positive rate of CRP in less prognosis goup （79.17%） was higher significantly than that in better prognosis group（39.02% ）（ P 〈 0.01 ）. The death rate of CRP positive patients （31.37 % ）was higher significantly than that of CRP negative patients（3.64% ）（ P 〈 0.01）. Conclusion Relationship between the serum CRP level and

关 键 词：老年 脑梗死 C-反应蛋白 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]