大动脉粥样硬化性脑梗死血清超敏C反应蛋白的临床意义  

Clinical significance of hs-CRP in large artery atherosclerosis stroke patients

作　　者：韩立堂[1] 滕继军[1] 刘广琴[2] 

机构地区：[1]青岛大学医学院附属医院神经内科,266003 [2]滕州市中心人民医院神经内科

出　　处：《中华脑血管病杂志（电子版）》2011年第5期25-29,共5页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

摘　　要：目的探讨大动脉粥样硬化不同机制所知脑梗死的血清超敏C反应蛋白(hs-CRP)的临床意义。方法采用中国缺血性卒中分型(CISS)分型方法,对临床诊断为大动脉粥样硬化型脑梗死根据发病机制分为4型,比较各组之间血清hs-CRP,并观察其余神经功能缺损程度以及不同机制类型梗死复发的关系。结果动脉-动脉栓塞型患者血清hs-CRP水平明显高于载体动脉阻塞穿支动脉型和混合型脑梗死组(P<0.01);低灌注/栓子清除障碍型患者血清hs-CRP水平明显高于载体动脉阻塞穿支动脉型(P=0.016),其他各组间比较差异无统计学意义。动脉-动脉栓塞型患者中大于6mg/L的例数明显高于载体动脉阻塞穿支动脉型和混合型脑梗死组(P<0.01);低灌注/栓子清除障碍型患者中大于6mg/L的例数明显高于载体动脉阻塞穿支动脉型(P<0.05)。中、重度神经功能缺损患者血清hs-CRP水平高于轻度神经功能缺损患者(P<0.01);重度神经功能缺损患者血清hs-CRP水平高于中度神经功能缺损患者(P<0.01)。发病早期NIHSS与动脉-动脉栓塞型患者血清Hs-CRP水平升高成正相关(P=0.01)。动脉-动脉栓塞型和混合型卒中复发率明显高于载体动脉阻塞穿支动脉型(P=0.001,0.022)。结论血清hs-CRP可反映大动脉粥样硬化型脑梗死患者中斑块的稳定性,对早期诊断、病情判断以及复发风险有一定的预测价值。Objectives To explore the clinical significance of high-sensitivity C-active protein （ hs- CRP） in the different mechanism of patients with large artery atheroselerosis stroke. Methods According to China ischemie stroke subelassification（CISS） criteria,divide LAA stroke patients into 4 different groups by mechanism, and compare the level of hs-CRP between each group ; observe the association of hs-CRP with severity of stroke and recurrence rate. Results The level of hs-CRP of artery-to-artery embolism group is higher than penetrating artery and multiple mechanisms group, and hypoperfusion/impaired emboli clearance group is higher than penetrating artery group（P 〈0.01 ）. The cases of hs-CRP level over 6 mg/L are much more in artery-to-artery embolism group than penetrating artery and multiple mechanisms group, and hypoperfusion/impaired emboli clearance group are more than penetrating artery group（P 〈0.01 ）. The levels of hs- CRP of moderate and severe severity group are higher than mild severity group; and the severe group is higher than moderate group. NIHSS of early stage is positive related with hs-CRP level. The recurrence rates in artery-to-artery embolism group and multiple mechanisms group are higher than penetrating artery group （ P 〈 0.01 ）. Conclusions The level of hs-CRP could reflect the stablebility of atherosclerosis plaque, and havepredict value in the early diagnosis of mechanism, severity of damage and possibility of recurrence.

关 键 词：动脉粥样硬化 脑梗死 发病机制 超敏C反应蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学]