高敏C反应蛋白和大动脉粥样硬化型卒中严重程度的相关性研究  

High-sensitivity C-reactive protein level correlates with the severity of large artery atherosclerosis stroke

作　　者：刘柯婷 周淑宇 蔡必扬 曹琴琴[1] 杨昉[1] 蔡晋[1] 王兆露[1] 刘新峰[1] 

机构地区：[1]南方医科大学金陵医院(南京军区南京总医院)神经内科,南京医学硕士210002

出　　处：《医学研究生学报》2015年第10期1043-1047,共5页Journal of Medical Postgraduates

基　　金：国家自然科学基金(81400332;81200892);江苏省自然科学基金(BK20141373)

摘　　要：目的高敏C反应蛋白（high-sensitivity C-reactive protein,hs-CRP）不仅可预测健康个体心脑血管事件风险,而且与急性脑卒中患者的功能预后密切相关。但hs-CRP与急性大动脉粥样硬化（large artery atherosclerosis,LAA）型脑卒中严重程度的关系尚未明确。文中旨在探讨血清hs-CRP水平和LAA型脑卒中严重程度的关系。方法回顾性收集2011年9月至2014年10月在南京军区南京总医院就诊的急性LAA型脑卒中患者251例。根据美国国立卫生研究院卒中量表（National Institute of Health stroke scale,NIHSS）≤3分定义为轻型卒中,NIHSS〉3分为重型卒中。根据hs-CRP值将患者分为低、中、高危3组,比较各组间临床特征。Logistic回归分析hs-CRP与卒中严重程度的关系。结果研究纳入的251例患者中,轻型卒中患者106（42.2%）例、重型卒中145（57.8%）例,轻型卒中患者中位hs-CRP水平显著低于重型卒中患者（2.00mg/L vs 3.15 mg/L,P=0.014）。相关分析示,患者hs-CRP值与入院NIHSS评分（γ=0.223,P〈0.001）、出院改良Rankin评分（modified Rankin Scales,mRS）（γ=0.188,P=0.003）显著相关。Logistics回归分析结果示,hs-CRP水平是LAA型重型卒中的危险因素（OR=1.54,95%CI：1.12~2.12,P=0.008）。结论 hs-CRP水平升高与LAA型重型卒中显著相关,故可作为急性LAA型卒中严重程度的一个有效预测指标。Objective High-sensitivity C-reactive protein（ hs-CRP） can be used to predict the risk of cardiocerebral vascular events and the functional outcome of acute ischemic stroke. However,the relation between hs-CRP and the severity of large artery atherosclerosis（ LAA） stroke remains equivocal. We aimed to investigate the correlation between hs-CRP and the severity of LAA stroke.Methods This study included 251 cases of acute LAA stroke treated in our hospital from September 2011 to October 2014,which were dichotomized into mild ischemic stroke（ NIHSS ≤ 3） and severe ischemic stroke（ NIHSS 3） at admission. Based on the hsCRP level,we divided the patients into a low risk（ 〈1. 0 mg / L）,a moderate risk（ 1. 0 to 3. 0 mg / L）,and a high risk group（ 〉3. 0mg / L） and evaluated the correlation between hs-CRP and the severity of LAA stroke by logistic regression analysis. Results Among the 251 cases,106（ 42. 2%） were mild and 145（ 57. 8%） were severe stroke,and the hs-CRP level was significant lower in the former than in the latter（ 2. 00 mg / L vs 3. 15 mg / L,P = 0. 014）. The hs-CRP value was significantly correlated with the NIHSS score at admission（ γ = 0. 223,P 〈0. 001） and the mRS score at discharge（ γ = 0. 188,P 〈0. 003）. Logistic regression analysis showed the increase of hs-CRP to be a risk factor for severe stroke in the acute LAA stroke patients（ OR = 1. 54,95% CI： 1. 12-2. 12,P = 0. 008）. Conclusion The elevated level of hs-CRP is significantly associated with severe LAA stroke and therefore can be regarded as an efficient predictor of stroke severity in LAA stroke patients.

关 键 词：高敏C反应蛋白 大动脉粥样硬化型卒中 重型卒中 

分 类 号：R543[医药卫生—心血管疾病]