不同海拔缺血性脑血管病患者血浆hs-CRP、FIB和血WBC变化与脑损害关系

目的通过检测不同海拔缺血性脑血管病患者血浆超敏C反应蛋白（hs-CRP）、纤维蛋白原（FIB）和血白细胞（WBC）数,并与对应海拔对照组比较,探讨上述炎症因子与缺血性脑血管病脑损害关系,及其对不同海拔地区缺血性脑血管病影响。方法选取世居西宁地区、海南州地区、宁夏地区住院急性缺血性脑血管病患者各40例作病例组;同期选取上述地区体检中心健康体检者各40例为对应地区对照组,采用散射比浊法测定血浆hs-CRP、凝固法测定FIB,同时测定血WBC数。并对所有缺血性脑血管病患者进行神经功能缺损评分及计算脑梗死体积。结果 1）三个不同海拔地区病例组上述炎症因子均高于对照组,差异具有统计学意义（P〈0.05）;2）三个不同海拔地区病例组上述炎症因子之间比较,海南州地区hs-CRP、FIB高于西宁地区和宁夏地区,西宁地区高于宁夏地区,差异具有统计学意义（P〈0.05）,而血WBC三地区间无差异;3）相关性分析显示：西宁地区缺血性脑血管病患者hs-CRP、FIB和血WBC与神经功能缺损评分及脑梗死体积呈正相关。结论血浆hs-CRP、FIB和血WBC对急性缺血性脑血管病的发生与发展存在影响,与高海拔地区患者脑损害密切相关;随着海拔增高和缺氧加重,患者血浆hs-CRP、FIB升高,导致脑损害加重可能,对其进行检测和干预可能对高原地区缺血性脑血管病的防治起特别作用。

CHANGES OF PLASMA hs-CRP,FIB AND WBC COUNT IN PATIENTS WITH ISCHEMIC CEREBROVASCULAR DISEASE AND THEIR CORRELATION WITH BRAIN DAMAGE AT DIFFERENT ALTITUDE

Objective To investigate the plasma level of high sensitivity C- reaction protein（ hs- CRP）,fibrinogen（ FIB） and white blood cell（ WBC） count and correlation with brain damage in patients with ischemic cerebrovascular disease and difference at different altitude. Method 40 native patients with acute ischemic cerebrovascular disease were selected from Qinghai university affiliated hospital and Hainan Tibetan autonomous prefecture hospital and Ningxia medical university affiliated cardia- cerebrovascular hospital from 2010 to 2013 as the case group,another 40 volunteers in the healthy center at the same period as the control group. Nephelometry was used to determine the concentration of plasma hs- CRP,coagulation method was used to determine the concentration of plasma FIB and the WBC was counted,NIHSS was scored and volume of cerebral infarction was calculated and then compared and analyzed. Results 1. The plasma hs- CRP,FIB level and the WBC count in case group were higher than those of control group,the differences had statistical significance（ P〈0. 05）. 2. The plasma level of hs-CRP,FIB and WBC count in patients at different altitude were compared that the plasma level of hs- CRP,FIB of patients in Hainan were higher than those in Xining and Ningxia,the plasma level of hs- CRP,FIB of patients in Xining were higher than those in Ningxia,the differences had statistical significance（ P〈0. 05）,the WBC count differences had no statistical significance（ P 〉0. 05）. 3. Correlation analysis showed that the plasma level of hs-CRP,FIB and WBC count were positively correlated with NIHSS and volume of cerebral infarction. Conclusion The plasma hs- CRP,FIB and WBC play an important role in occurrence and development of acute ischemic cerebrovascular disease and are closely related to brain damage. The plasma hs- CRP,FIB concentration increase and brain damage aggravate with the increase of elevation and hypoxia,detection and interference of the plasma hs-CRP,FIB maybe play an important role in p