超敏C反应蛋白与微栓子信号对动脉粥样硬化性急性脑梗死患者短期预后影响  

Effects of High-sensitivity C-reactive Protein and Microembolic Signal on Short-term Prognosis of Patients with Acute Atherosclerotic Cerebral Infarction

作　　者：平会坤 王亚 于彩敏[1] 代红兰 刘丽[1] PING Hui-kun;WANG Ya;YU Cai-min;DAI Hong-lan;LIU Li(Department of Neurology,People's Hospital of Dingzhou County,Dingzhou,Hebei 073000,China)

机构地区：[1]定州市人民医院神经内科

出　　处：《解放军医药杂志》2020年第1期51-55,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省卫生厅计划项目(20191750)

摘　　要：目的探讨血清超敏C反应蛋白(hs-CRP)与经颅多普勒超声微栓子信号对于大动脉粥样硬化性急性脑梗死患者短期预后影响。方法选择2017年1月—2018年1月诊断为大动脉粥样硬化性急性脑梗死患者240例,入院24 h内给予免疫比浊法检测血清hs-CRP水平,经颅多普勒超声检测微栓子信号。依据患者入院72 h内是否发生进展性脑卒中分为进展组31例与稳定组209例。依据患者住院14 d临床疗效分为良好组189例与不良组51例。随访1年,依据是否发生血管性认知障碍分为血管性认知障碍组26例与对照组214例。分析患者发生血管性认知障碍危险因素。结果进展组血清hs-CRP水平与微栓子信号阳性率高于稳定组(P<0.01)。疗效良好组血清hs-CRP水平与微栓子信号阳性率低于不良组(P<0.01)。年龄、血清hs-CRP水平、微栓子信号阳性为患者血管性认知障碍发生的独立危险因素(P<0.01)。结论大动脉粥样硬化性急性脑梗死发生后,血清hs-CRP水平与微栓子信号阳性是患者短期预后不良危险因素,提示临床应加强血管内皮功能稳定性控制。Objective To investigate effect of serum high-sensitivity C-reactive protein(hs-CRP)and transcranial Doppler ultrasonography microembolic signal on short-term prognosis of patients with acute cerebral infarction caused by large atherosclerosis.Methods A total of 240 patients with acute cerebral infarction who were diagnosed as having atherosclerotic type during January 2017 and January 2018 were recruited in this study.Within 24 h after admission,serum hs-CRP levels were detected by immunoturbidimetry,and values of microembolic signal were detected by transcranial Doppler ultrasound.The patients were divided into progressive group(n=31)and stable group(n=209)according to whether or not having progressive stroke within 72 h after admission.According to clinical effect on the 14 th d of hospitalization,the patients were divided into good effect group(n=189)and poor effect group(n=51).After 1 year of follow-up,the patients were divided into vascular cognitive disorder group(n=26)and control group(n=214)according to whether or not having vascular cognitive disorder.Risk factors of vascular cognitive disorder were analyzed.Results Serum hs-CRP levels and positive rates of microembolic signal in progressive group were significantly higher than those in stable group(P<0.01).Serum hs-CRP levels and positive rates of microembolic signal in good effect group were significantly lower than those in poor effect group(P<0.05).Age,serum hs-CRP level and positive microembolic signal were independent risk factors for vascular cognitive disorder(P<0.01).Conclusion Serum hs-CRP level and positive microembolic signal are risk factors for poor short-term prognosis of patients with acute cerebral infarction caused by large atherosclerosis,which suggests that control of vascular endothelial function stability should be strengthened in clinic.

关 键 词：脑梗死 动脉粥样硬化 超敏C反应蛋白 微栓子信号 血管性认知障碍 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]