hs-CRP、Hcy水平与脑卒中的发生及预后的关系分析  

The correlation between the levels of hs-CRP and Hcy and the occurrence and prognosis of stroke

作　　者：赵丽[1] ZHAO Li(Department of Neurology,Nantong Rich Hospital,Nantong 226009,China)

机构地区：[1]南通瑞慈医院神经内科,226009

出　　处：《中国实用医药》2022年第20期37-40,共4页China Practical Medicine

摘　　要：目的研究脑卒中后超敏C反应蛋白(hs-CRP)及同型半胱氨酸(Hcy)的临床水平,探讨hs-CRP、Hcy与脑卒中患者的预后、脑卒中后抑郁的关系。方法选择30例健康体检者做为A组;59例脑卒中患者为B组,其中34例有动脉粥样硬化斑块的急性脑梗死(ACI)患者作为B1组,25例其他的卒中患者作为B2组;42例卒中后不同抑郁程度患者作为C组,根据抑郁严重程度分为C1组(12例)、C2组(16例)、C3组(14例);17例卒中后无抑郁的患者作为D组。比较A组、B组、B1组、B2组的血清hs-CRP、Hcy水平及死亡率;比较A组、C组、C1组、C2组、C3组、D组的血清hs-CRP、Hcy水平及汉密尔顿抑郁量表(HAMD)评分,分析hs-CRP、Hcy与卒中后抑郁的相关性;比较A组、C组、D组的hs-CRP、Hcy高水平发生情况。结果B组的hs-CRP(6.72±2.64)mg/L,Hcy(20.43±4.73)μmol/L高于A组的(2.14±1.53)mg/L、(12.17±3.22)μmol/L,B1组的hs-CRP(7.85±2.97)mg/L、Hcy(21.38±5.14)μmol/L高于B2组的(5.91±2.32)mg/L、(19.73±3.98)μmol/L,差异均有统计学意义(P<0.05)。B1组的死亡率8.8%高于B2组的4.0%,但差异无统计学意义(P>0.05)。C组、D组的HAMD评分、hs-CRP、Hcy水平均高于A组,差异有统计学意义(P<0.05)。hs-CRP水平与卒中后抑郁程度无相关性(r=0.103,P>0.05);HAMD评分、Hcy水平与卒中后抑郁程度呈正相关(r=0.397、0.412,P<0.05)。C组、D组的hs-CRP高水平发生率分别为45.2%(19/42)、41.2%(7/17),高于A组的13.3%(4/30);Hcy高水平发生率分别为69.0%(29/42)、47.1%(8/17),高于A组的16.7%(5/30),差异均有统计学意义(P<0.05)。结论血清hs-CRP、Hcy的高水平是发生卒中、动脉粥样硬化斑块形成的危险因素,会严重影响脑卒中患者的预后;脑卒中后患者的Hcy高水平与抑郁存在相关性。Objective To study the clinical levels of high-sensitivity C-reactive protein(hs-CRP)and homocysteine(Hcy)after stroke,and explore the correlation between hs-CRP,Hcy and the prognosis and poststroke depression of stroke patients.Methods 30 healthy subjects were selected as group A;59 stroke patients were selected as group B,including 34 patients with acute cerebral infarction(ACI)with atherosclerotic plaques as group B1,and 25 other stroke patients as group B2;42 patients with different degrees of depression after stroke were selected as group C,and were divided into C1 group(12 cases),C2 group(16 cases)and C3 group(14 cases)according to the severity of depression;17 patients without depression after stroke were selected as group D.The levels of serum hs-CRP,Hcy and mortality were compared among groups A,B,B1 and B2.The serum hs-CRP,Hcy levels and Hamilton Depression Scale(HAMD)scores were compared among groups A,C,C1,C2,C3,and D,and the correlation between hs-CRP,Hcy and post-stroke depression was analyzed.The occurrence of high levels of hs-CRP and Hcy in groups A,C and D were compared.Results The hs-CRP(6.72±2.64)mg/L and Hcy(20.43±4.73)μmol/L in group B were higher than(2.14±1.53)mg/L,(12.17±3.22)μmol/L in group A;the hs-CRP(7.85±2.97)mg/L and Hcy(21.38±5.14)μmol/L in group B1 were higher than(5.91±2.32)mg/L and(19.73±3.98)μmol/L in the B2 group;all the differences were statistically significant(P<0.05).The mortality rate 8.8%of group B1 was higher than 4.0%of group B2,but the difference was not statistically significant(P>0.05).The HAMD score,hs-CRP and Hcy levels of group C and group D were higher than those of group A,and the difference was statistically significant(P<0.05).There was no correlation between hs-CRP level and degrees of post-stroke depression(r=0.103,P>0.05).HAMD score and Hcy level were positively correlated with post-stroke depression(r=0.397,0.412;P<0.05).The incidence of high levels of hs-CRP in groups C and D were 45.2%(19/42)and 41.2%(7/17),which were higher than 13.3%(4/30)

关 键 词：脑卒中 超敏C反应蛋白 同型半胱氨酸 抑郁 

分 类 号：R743.3[医药卫生—神经病学与精神病学]