蛋白C、蛋白S、C反应蛋白、同型半胱氨酸在脑卒中病情及预后评估中的作用  

Disease Condition and Prognosis Evaluation Role of Protein C,Protein S,C-reactive Protein and Homocysteine in Stroke Patients

作　　者：齐晓艳[1] 曹永峰[1] 吕勃 肖波[3] 王光辉[4] 张艳玲[1] 

机构地区：[1]保定市第五医院检验科,河北保定071000 [2]保定市法医医院鉴定科,河北保定071000 [3]保定市第五医院耳鼻咽喉科,河北保定071000 [4]保定市第五医院超声科,河北保定071000

出　　处：《医学综述》2016年第12期2407-2410,共4页Medical Recapitulate

摘　　要：目的探讨蛋白C、蛋白S、C反应蛋白（CRP）、同型半胱氨酸（Hey）在脑卒中病情及预后评估中的作用。方法将2013年7月至2014年4月保定市第五医院收治的脑卒中患者140例分为缺血性卒中纽（68例）和出血性脑卒中组（72侧），另选择同期在医院体检的健康人群60例作为对照组；140例脑卒中患者随访6-12个月，按照神经功能缺损程度分为轻度组（31例）、中度组（64例）和重度组（45例）。检测各组受试对象蛋白c、蛋白S、CRP、Hey、纤维蛋白原、总胆固醇、三酰甘油水平，并计算神经功能缺损程度与蛋白C、蛋白S、CRP、Hey的相关性。结果缺血性卒中组、出血性脑卒中组CRP、Hey显著高于对照组[（23．8±3．1）mg／L，（24．1±3．6）mg／L比（5．7±0．5）mg／L；（39±4）μmol／L，（40±5）μmol／L比（28±3）μmol／L]（P〈0．05），缺血性卒中组、出血性脑卒中组间ClIP、Hey比较差异无统计学意义（P〉0．05）。重度组、中度组CRP、Hey水平显著高于轻度组[（47．3±5．8），（28．7±3．4）mg／L比（17．9±2．5）mg／L；（45±6），（41±5）μmol／L比（30±4）μmol／L]（P〈0．05），重度组CRP、Hey水平显著高于中度组（P〈0．05）。相关性分析显示，CRP、Hey与神经功能缺损程度呈显著正相关（r=0．636，0．538，P〈0．05），蛋白C、蛋白S与神经功能缺损无明显相关性（r=0．057，0．085，P〉0．05）。结论CRP、Hey与脑卒中的发病密切相关，CRP、Hey检测能够作为评估脑卒中预后的指标之一。Objective To explore the disease condition and prognosis evaluation role of protein C,pro- tein S, C-reactive protein （CRP） and honaocysteine （Hcy ） in stroke patients. Methods A total of 140 stroke patients in Baoding Fifth Hospital during Jul. 2013 and Apr. 2014 were divided into 68 cases of cerebral infarction group and 72 cases of cerebral hemorrhage group, another 60 healthy people for physical examination during the same period were included as a control group. The stroke patients were followed up for 6 to 12 months,according to the degree of nerve function defect they were divided into mild group of 31 cases, moderate group of 64 cases and severe group of 45 cases. The levels of protien C, protien S, CRP,fibrinogen （FIB）, Hey, triglyceride （TG）, total cholesterol in each group were detected, and the correlations between protein S, CRP, Hcy and protein C were analyzed. Results CRP [ （ 23.8 ± 3. 1 ）, （ 24. 1 ±3.6 ） mg/L ], Hcy[ （39 24 ）, （40 ± 5 ） μmol/L] in cerebral infarction group and cerebral hemorrhage group were significandy higher than the control group [ （5.7 ± 0. 5 ） mg/L, （27. 6 ± 3.3 ） μmol/L ] （ P 〈 0. 05 ） ; there was no significant difference in CRP and Hcy between cerebral infarction group and cerebral hemorrhage group（ P 〉 0.05）.The levels of CRP[ （47.3 ±5.8） ,（28.7 ±3.4） mg/L] ,Hcy[ （45 ±6） ,（41 ±5） l.Lmol/L] in the severe group and moderate group were significantly higher than the mild group [ （17.9 ± 2. 5 ） mg/L, （30 ± 4 ） μmol/L ] （P 〈 0. 05 ）, while the CRP and Hcy level of the severe group were significantly higher than the moderate group （ P 〈 0. 05 ）. Correlation analysis showed that CRP and Hey were significantly correlated with the degree of neurological impairment （r = 0. 636,0. 538 ,P 〈 0. 05 ）, while protein S and protein C was not significantly correlated with （ r = 0. 057,0. 085,P 〉 0. 05 ）. Conclusion CRP, Hcy are closely related to the onset of stroke,and Hey and

关 键 词：神经功能缺损 蛋白C 蛋白S C反应蛋白 同型半胱氨酸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]