高敏C反应蛋白与脑白质疏松症的相关性研究  

Correlation between high-sensitivity C-reactive protein and leuko-araiosis

作　　者：黄勇华[1] 王国强[1] 林琅[1] 张微微[1] 魏微[1] 郭文华[1] 李莉[1] 

机构地区：[1]北京军区总医院神经内科,北京100700

出　　处：《解放军医学杂志》2009年第7期888-890,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨高敏C反应蛋白(hs-CRP)与腔隙性脑梗死患者脑白质疏松症(LA)的相关性。方法回顾性分析2006年1月-2008年7月北京军区总医院神经内科收治的因急性腔隙性脑梗死住院的患者206例,其中确诊LA118例。根据头颅核磁共振(MRI)所见,将其按照Fazekas评分标准分为无/轻度组(0～1分)和中/重度组(2～3分)。比较两组患者的年龄、性别、吸烟史、冠心病史、总胆固醇、低密度脂蛋白、收缩压、舒张压、血糖和hs-CRP的差异。结果无/轻度组55例,中/重度组63例;两组患者的年龄(65.8±12.4、74.5±10.8岁,P=0.000),冠心病史(15、37例,P=0.001)、收缩压(127.93±17.54、147.28±20.90mmHg,P=0.000)和舒张压(77.00±12.99、84.89±12.54mmHg,P=0.001)均有显著性差异,提示其均为LA的相关危险因素。两组患者hs-CRP(分别为8.47±1.79mg/L和9.77±2.12mg/L)的差异显著(P=0.001);进一步剔除年龄、冠心病史、总胆固醇、血压等因素,发现两组的hs-CRP仍有统计学差异(OR=1.295,95%CI:1.008～1.665;P=0.043)。结论hs-CRP可能参与LA的发病机制。Objective To explore the correlation between high-sensitivity C-reactive protein （hs-CRP） and lenko-araiosis （LA） in patients with lacunar infarction. Methods In 206 patients with acute lacunar infarction, consecutively admitted to the Department of Neurology of General Hospital of Beijing Command from Jan. 2006 to Jul. 2008, the data including thair bs-CRP levels and brain MRI scanning were retrospectively analyzed. Among them 118 patients were finally diagnosed to have LA. The severity of LA in the white matter was classified into two groups according to Fazekas＇ standard： absent/mild （a score of 0--1） and moderate/severe （a score of 2--3）. The differences were compared between the two groups in age, gender, history of smoking, coronary artery disease, blood cholesterol and low density lipoprotein levels, systolic pressure, diastolic pressure, blood glucose and hs-CRP. Results According to Fazekas＇ standard, 55 patients belonged to the absent/mild group and 63 to the moderate/severe group. Significant differences existed between absent/mild group and moderate/severe group in age （65. 82±12. 40 vs 74. 50±10. 81, P=0. 000）, cases with history of coronary artery disease （15 vs 37, P=0. 001）, systolic pressure （77. 00 ± 12. 99 vs 84. 89 ± 12. 54mmHg, P= 0. 001） and diastolic pressure （77. 00 ± 12. 99 vs 84. 89 ± 12. 54mmHg, P=0. 001）, implying that they were all the risk factors for LA. Advanced analysis using binary logistic regression demonstrated that statistical difference still existed between the two groups in hs-CRP level even if rejecting the factors of age, history of coronary artery disease, cholesterol and blood pressure （8. 47 ±1. 79mg/L vs 9. 77 ± 2. 12mg/L; OR= 1. 295, 95% CI： 1. 008 ± 1. 665; P= 0. 043）. Conclusion It seems that hs-CRP may be involved in the pathogenesis of the development of LA.

关 键 词：脑白质疏松症 C反应蛋白质 老年人 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R364[医药卫生—临床医学]