炎性标记物对急性脑梗死早期预后的影响

目的探讨炎性标记物对急性脑梗死早期预后的影响。方法连续收集急性脑梗死患者272例,根据高敏C反应蛋白(hs-CRP)水平分为高hs-CRP组(hs-CRP>3mg/L,116例)和低hs-CRP组(hs-CRP≤3mg/L,156例)。入院后行TOAST分型,美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)评分和改良Rankin量表(mRS)评分;检测入院后24h内血白细胞、空腹血糖、同型半胱氨酸和hs-CRP;并采用多因素logistic回归分析对急性脑梗死早期预后不良的独立危险因素进行探讨。结果高hs-CRP组年龄、心房颤动、TOAST分型心源性栓塞、同型半胱氨酸、空腹血糖、白细胞和1、7、14dNIHSS评分及1、7、14、90dmRS评分明显高于低hs-CRP组,1、7、14dBI评分明显低于低hs-CRP组,2组比较差异有统计学意义(P<0.01)。hs-CRP、白细胞、高脂血症、入院1d时BI评分是急性脑梗死早期预后不良的独立危险因素。结论炎性标记物hs-CRP及白细胞计数增高可能是急性脑梗死早期预后不良的独立危险因素。

Effect of inflammatory markers on early outcome in acute ischemic stroke patients

Objective To study the effect of inflammatory marker,hs-CRP,on early outcome in acute ischemic stroke patients.Methods Two hundred and seventy-two acute ischemic stroke patients were devided into hs-CRP>3mg/L group(n=116)and hs-CRP≤3mg/L group(n=156). Their TOAST grade,NIHSS score,Barthel index(BI)score and modified Rankin scale(mRS) score were recorded after admission.Their white blood cells,serum levels of fasting blood glucose,homocysteine and hs-CRP were measured.The independent risk factors for the poor ealy outcome in acute ischemic stroke patients were analyzed by multivariate logistic regression analysis.Results The age was older,the TOAST grade,the incidence of atrial fibrillation and cerebral embolism,the serum levels of homocysteine and fasting blood glucose,the number of white blood cells,the NIHSS score on days 1,7,14after admission and the mRS score on days 1,7,14,90after admission were significantly higher,whereas the BI score on days 1,7,14after admission was significantly lower in hs-CRP>3mg/L group than in hs-CRP≤3mg/L group(P<0.01).hs-CRP, white blood cells,hyperlipidemia and BI score 1day after admission were the independent risk factors for the poor early outcome in acute ischemic stroke patients.Conclusion Increased serum hs-CRP level and white blood cells may be the independent risk factors for the poor early outcome in acute ischemic stroke patients.