不同TOAST分型急性脑梗死患者血清hs-CRP和LDL水平变化及临床意义  

The changes of serum hs-CRP and LDL Levels in patients with acute cerebral infarction of different TOAST types and its clinical significance

作　　者：谷黎丽 田勇武 贺丹[1] 

机构地区：[1]河北医科大学第二医院神经内科,河北石家庄050000 [2]河北省定州市第二医院神经内科,河北定州073000

出　　处：《河北医科大学学报》2017年第5期514-519,524,共7页Journal of Hebei Medical University

摘　　要：目的检测不同TOAST分型急性脑梗死患者血清高敏C反应蛋白(high sensitive-C reactive protein,hs-CRP)和低密度脂蛋白(low density lipoprotein,LDL)水平,探讨hs-CRP和LDL在不同类型脑梗死急性期的作用及临床意义。方法选取脑梗死患者374例为病例组,健康志愿者60例为正常对照组。病例组患者按照TOAST分型分为大动脉粥样硬化组(large-artery atherosclerosis,LAA)158例、小动脉闭塞组(small-artery occlusion,SAO)171例和心源性栓塞组(cardioembolism,CE)45例。所有受试者于次日清晨空腹抽取肘静脉血3mL,测定血清hs-CRP和LDL水平。结果 LAA、SAO、CE组美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、收缩压、舒张压明显高于对照组,LAA组和CE组NIHSS评分高于SAO组,LAA、SAO组收缩压高于CE组。LAA、SAO组吸烟、糖尿病发生率高于对照组和CE组,SAO组饮酒发生率高于对照组,LAA、SAO、CE组高血压、高脂血症、心脏病发生率高于对照组,CE组心脏病发生率高于LAA组和SAO组。LAA、SAO、CE组血清hs-CRP水平高于对照组,CE组血清hs-CRP水平高于LAA、SAO组,LAA组血清hsCRP水平高于SAO组。LAA、SAO组血清LDL水平高于对照组(P<0.05)。急性脑梗死患者血清hs-CRP水平与LDL、NIHSS评分呈正相关(rs=0.164、0.183,P<0.05)。二分类Logistic回归分析结果显示,收缩压、hs-CRP是心源性脑栓死的危险因素。结论在TOAST亚型中,血清hs-CRP可作为CE的危险因素,成为脑梗死发病早期判定病因学分类的指标。LDL有望成为LAA的特异性生化指标,对早期预测LAA有重要临床价值。Objective To investigate the effects of high sensitive-C reactive protein（hs-CRP） and low density lipoprotein（LDL） levels in patients with acute cerebral infarction, and to investigate the effects of hs-CRP and LDL on the acute cerebral infarction and its clinical significance. Methods Three hundred and seventy-four cases of cerebral infarction were selected as the case group and 60 healthy volunteers were normal control group. In the case group, 158 patients with large-artery atherosclerosis（LAA）, 171 patients with small artery occlusion（SAO） and 45 cases with cardioembolism（CE） were divided into three groups according to TOAST classification. All the subjects were given 3 mL of venous blood in the early morning of the next day, and the levels Of serum hs-CRP and LDL were measured. Results National Institute of Health stroke scale（NIHSS） score, systolic blood pressure and diastolic blood pressure of LAA,SAO and CE group were significantly higher than those of control group. The NIHSS score of LAA group and CE group was higher than that of SAO group, and the systolic blood pressure of LAA group and SAO group was higher than that of CE group. LAA, SAO group were higher than the control group and CE group. SAO group was higher than the control group, LAA, SAO, CE group of hypertension, hyperlipidemia, he＇art disease rate was higher than the control group. The incidence of heart disease in CE group was higher than that in LAA group and SAO group. The levels of serum hs-CRP in LAA, SAO and CE group were higher than those in LAA group and SAO group, and the level of serum hs-CRP in LAA group was higher than that in SAO group. The level of serum LDL in LAA and SAO group was higher than that in control group（P〈0.05）. The levels of serum hs-CRP in patients with acute cerebral infarction were positively correlated with LDL and NIHSS scores （rs= 0.164, 0.183, P〈0.05）. Logistic regression analysis showed that systolic blood pressure and hs-CRP were risk factors .for cardioembolism. Conc

关 键 词：脑梗死 C反应蛋白质 脂蛋白类 LDL 

分 类 号：R743.33[医药卫生—神经病学与精神病学]