急性脑梗死患者血清胱抑素C和C反应蛋白水平变化的研究  

Alteration of the level of serum Cys-C and CRP in patients with acute cerebral infarction

作　　者：诸兴明[1] 陈阳[1] 杜宇平[1] 马莉[1] 

机构地区：[1]解放军101医院神经内科,江苏无锡214044

出　　处：《东南国防医药》2014年第3期275-277,共3页Military Medical Journal of Southeast China

摘　　要：目的探讨急性脑梗死患者血清胱抑素C(cystatin C,Cys-C)和C反应蛋白(CRP)水平对病情变化及预后判断的意义。方法选择颈动脉系统进展性脑梗死70例为进展组,非进展性脑梗死168例为非进展组,分别于入院次日(第1天)、第3、7和14天检测血清Cys-C和CRP浓度,行颈部血管超声和经颅多普勒超声(transcranial Doppler sonography,TCD)检查,以及卒中量表(National Institutes of Health Stroke Scale,NIHSS)和Barthel指数(Barthel index,BI)评分。结果进展组患者入院时颅/颈动脉狭窄率高于非进展组(44.3%vs 29.8%,P<0.05),非进展组患者血清Cys-C浓度在第7、14天下降,血清CRP浓度在第3、7、14天下降,进展组患者Cys-C和CRP浓度在第3天明显增加,Cys-C浓度在第14天下降,CRP浓度在第7、14天下降,明显高于非进展组(P<0.01)。进展组NIHSS和BI评分在入院后进行性增高,非进展组NIHSS和BI评分呈下降趋势(P<0.01)。结论观察血清Cys-C及CRP浓度的变化有助于早期发现和及时处理进展性脑梗死。Objective To explore the signification of variation of serum Cys-C and CRP in patients with acute cerebral infarc-tion in the evolution of illness and the prognosis .Methods 70 patients with progressive crotid system cerebral infarction were selected as progressive group ,and 168 patients with non-progressive crotid system cerebral infarction were selected as non-progressive group .We respectively tested the content of serum Cys-C and serum CRP,used the carotid ultrasonography and TCD to do the examination and to evaluate the level of NIHSS and BI on the 2nd day of admission （1st day）,the 3rd day,the 7th day,and the 14th day.Results The vascular stenosis rate in the progressive group was higher than that in the non-progressive group （44.3%vs 29.8%,P〈0.05）.In the non-progressive group,the content of serum Cys-C descended on the 7th day and the 14th day,and the content of serum CRP descended on the 3rd day,the 7th day and the 14th day.In the progressive group ,the content of serum Cys-C and serum CRP increased prominant-ly on the 3rd day,the content of serum Cys-C decreased on the 14th day and serum CRP on the 7th day and the 14th day,which was much higher than that in non-progerssive group （P〈0.01）.The scores of NIHSS and BI were increased gradually in progressive group , while it showed a down trend in non-progressive group （P〈0.01）.Conclusion It is conductive to early detect and immediate treat-ment to the progressive cerebral infarction with the observation of the change of serum Cys -C and serum CRP .

关 键 词：脑梗死 胱抑素C C反应蛋白 进展性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]