老年缺血性脑卒中后疲劳病人神经功能及远期预后的相关因素分析  

Correlation of serum CAM,hs-CRP,Hcy and IL-1β levels with neurological function and longterm prognosis in elderly patients with fatigue after ischemic stroke

作　　者：王婷 白琳 熊飞[2] WANG Ting;BAI Lin;XIONG Fei(Department of Clinical Laboratory,Wuhan Central Hospital Affiliated to Tongji Medical Collage of Huazhong University of Science and Technology,Wuhan 430000,China;Department of Clinical Laboratory,the Children's Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430000,China)

机构地区：[1]华中科技大学同济医学院附属武汉中心医院检验科,湖北省武汉市430000 [2]华中科技大学同济医学院附属武汉儿童医院检验部,湖北省武汉市430000

出　　处：《实用老年医学》2019年第9期871-875,共5页Practical Geriatrics

摘　　要：目的探讨血清钙调蛋白(calmodulin,CAM)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、同型半胱氨酸(homocysteine,Hcy)及白细胞介素1 β(interleukin 1 β,IL-1 β)水平与老年缺血性脑卒中后疲劳病人神经功能及远期预后的相关性。 方法回顾性分析2016年7月至2017年8月在本院接受治疗的96例老年缺血性脑卒中病人的临床资料,根据疲劳严重度量表评分将其分为疲劳组41例与非疲劳组55例。记录2组病人入院时及治疗后不同时间点血清CAM、hs-CRP、Hcy、IL-1 β水平及美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分与改良Rankin量表(modified Rankin Scale,mRS)评分,并进行比较,采用Spersman等级相关分析NIHSS、mRS评分与血清CAM、hs-CRP、Hcy及IL-1 β水平之间的相关性。 结果 2组病人治疗后3、6、12个月CAM、hs-CRP、Hcy及IL-1 β水平与入院时比较,差异均有统计学意义( P < 0.05);且疲劳组病人入院时及治疗后3、6、12个月CAM、hs-CRP、Hcy及IL-1β水平均明显高于非疲劳组(P<0.05)。治疗后3、6、12个月,2组病人NIHSS评分及mRS评分均依次降低,疲劳组病人入院时及治疗后3、6、12个月NIHSS评分及mRS评分均明显高于非疲劳组(P<0.05)。老年缺血性脑卒中后疲劳病人NIHSS评分与血清CAM、hs-CRP、Hcy及IL-1 β水平均呈正相关(r分别为0.826、0.603、0.695、0.781, P < 0.05);mRS评分与血清CAM、hs-CRP、Hcy及IL-1 β水平亦呈正相关( r 分别为0.677、0.579、0.792、0.724, P<0.05)。 结论老年缺血性脑卒中后疲劳病人神经功能缺损程度较为严重,且治疗后远期预后较差,NIHSS评分及mRS评分与血清CAM、hs-CRP、Hcy及IL-1β水平均呈明显正相关。Objective To discuss the correlation of serum calmodulin(CAM),hypersensitive C-reaction protein(hs-CRP),homocysteine(Hcy) and interleukin-1 β(IL-1 β) levels with neurological function and long-term prognosis in the elderly patients with fatigue after ischemic stroke. Methods A retrospective analysis of the clinical data of 96 elderly patients with fatigue after ischemic stroke treated in our hospital from July 2016 to August 2017 was conducted. According to the score of fatigue severity scale,they were divided into the fatigue group(41 cases) and the non-fatigue group(55 cases). The serum levels of CAM,hs-CRP,Hcy,IL-1 β and NIHSS scores,mRS scores of two groups at different time points after treatment were detected,and the correlations of NIHSS,mRS score with serum levels of CAM,hs-CRP,Hcy and IL-1 β were analyzed by Spersman rank correlation analysis. Results The levels of CAM,hs-CRP,Hcy and IL-1 β of the two groups 3,6 and 12 months after treatment were statistically lower than those before treatment( P < 0.05). Moreover,the levels of CAM,hs-CRP,Hcy and IL-1 β in the fatigue group were significantly higher than those in non-fatigue group at admission time and 3,6 and 12 months after treatment( P < 0.05). The NIHSS scores and mRS scores of the two groups decreased at a time-dependent manner. The NIHSS and mRS scores of the fatigue group were significantly higher than those of the non-fatigue group at admission time and 3,6 and 12 months after treatment( P < 0.05). The NIHSS score was positively correlated with serum CAM,hs-CRP,Hcy and IL-1 β levels in the elderly patients with fatigue after ischemic stroke(the correlation coefficients were 0.826,0.603,0.695,0.781 respectively, P < 0.05);The mRS score was positively correlated with serum CAM,hs-CRP,Hcy and IL-1 β levels(the correlation coefficients were 0.677,0.579,0.792,0.724 respectively, P < 0.05). Conclusions The severity of neurological deficit in the patients with fatigue after ischemic stroke is more serious and the long-term prognosis is worse aft

关 键 词：缺血性脑卒中 疲劳 神经功能 远期预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]