同型半胱氨酸、N端脑钠肽前体及超敏C反应蛋白在缺血性脑卒中患者中的临床价值  

The clinical value on plasma homocysteine,N-terminal prohormone of brainnatriuretic and high sensitivity C reactive protein in patients with ischemic stroke

作　　者：王敏[1] 汪春华[1] 刘群[1] 徐转[1] 

机构地区：[1]蚌埠医学院第二附属医院检验科,安徽蚌埠233040

出　　处：《蚌埠医学院学报》2014年第7期956-959,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨同型半胱氨酸(homocysteine,Hcy)、N端脑钠肽前体(N-terminal prohormone of brainnatriuretic,NT-proBNP)及超敏C反应蛋白(high sensitivity C reactive protein,hs-CRP)与缺血性脑卒中(ischemic stroke,IS)初发和复发的相关性,为临床诊断、病情评估和预后判断提供科学依据。方法:以216例IS患者为研究对象,其中初发134例,复发82例,并选取100名健康体检者为对照组,分别检测3组受试者的Hcy、NT-proBNP、hs-CRP的变化水平,同时对IS初发和复发的因素进行多元logistic回归分析。结果:初发和复发IS患者的Hcy、NT-proBNP和hs-CRP水平均显著高于对照组(P<0.01),且复发组的Hcy、NT-proBNP和hs-CRP水平均明显高于初发IS组(P<0.01);复发IS组Hcy、NT-proBNP、hs-CRP高于正常范围值患者分别占56.10%、38.06%和74.39%,均显著高于初发IS组的38.06%、26.87%和36.57%(P<0.01);多元logistic回归分析Hcy、NT-proBNP和hs-CRP水平的升高均是IS初发的独立危险因素,而罹患糖尿病和机体Hcy、NT-proBNP和Hs-CRP水平的升高均是IS复发的独立危险因素。结论:IS患者的Hcy、NT-proBNP、hs-CRP水平显著高于健康人群,且复发IS的检测指标水平亦高于初发患者,高水平的Hcy、NT-proBNP、hs-CRP均是IS初、复发的独立高危因素。Objective：To investigate the relationships among the levels of plasma homocysteine （Hcy）,N-terminal prohormone of brainnatriuretic（NT-proBNP）,high sensitivity C reactive protein（hs-CRP） and ischemic stroke（IS） onset and recurrence,and provide the scientific basis for clinical diagnosis,condition assessment and prognosis.Methods：Total 216 patients with IS from Dec.2011 to Aug.2013 were recruited,134 cases with IS initial onset,and 82 cases with recurrence,meanwhile 100 healthy persons were selected as control group.Plasma Hcy,NT-proBNP and hs-CRP levels in the three groups were measured.The factors in IS initial onset and recurrence were carried out in multiple logistic regression analysis.Results：The plasma Hcy,NT-proBNP and hs-CRP levels in primary and recurrent IS patients were significantly higher than that in control group （P ＜ 0.01） ; Hcy,NT-proBNP and hs-CRP levels in the recurrence group were significantly higher than that in the initial onset group （P ＜ 0.01） ; Hcy,NT-proBNP and hs-CRP levels in recurrent group accounted for 56.10％,38.06％ and 74.39％ above the normal range,which were significantly higher than 38.06％,26.87％ and 36.57％ in primary group（P ＜ 0.01）;the multiple logistic regression analysis results displayed the rise of Hcy,NT-proBNP and hs-CRP levcls were IS independent risk factors for the inifial onset（P ＜ 0.01） ;diabetes and the rise of Hcy,NT-proBNP and hs-CRP levels were the independent risk factors for the recurrence of IS （P ＜ 0.01）.Conclusions：Plasma Hcy,NT-proBNP,hs-CRP levels in IS patients are significantly higher than in healthy people,and Hcy,NT-proBNP,hs-CRP levels in the recurrence IS are also higher than in the initial onset.High levels of Hcy,NT-proBNP and hs-CRP are all IS independent risk factors for recurrence.

关 键 词：缺血性脑卒中 同型半胱氨酸 脑钠肽 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]