超敏C-反应蛋白结合同型半胱氨酸预测急性缺血性脑卒中短期预后

目的研究超敏C-反应蛋白(Hs-CRP)和同型半胱氨酸(HCY)水平与急性缺血性脑卒中短期预后的关联性。方法前瞻性研究189 例首次发病的急性缺血性脑卒中患者。入院后进行血清Hs-CRP、HCY水平检测与美国国立卫生研究院卒中量表(NIHSS)评分。入院90 d 后通过改良Rankin 量表(mRS)测定短期功能结果。结果脑卒中组血清Hs-CRP和HCY水平显著高于健康对照组(P<0.001)。调整NIHSS和年龄等其他危险因素后，Hs-CRP和HCY是功能结果和死亡的独立的预测因素。通过受试者操作特征曲线(ROC)曲线下面积分析，HCY和HS-CRP结合模型的预测准确度明显高于各生物标志物单独测量和NIHSS评分。结论Hs-CRP和HCY是脑卒中短期预后的独立预测因素。组合模型可以提供额外的预后信息。

Prediction of Combination of High-sensitivity C-reactive Protein and Homocysteine on Short-term Outcomes of Patients with Acute Ischemic Stroke

Objective To explore the relationship of high-sensitivity C-reactive protein (Hs-CRP), homocysteine (HCY) levels and the short-term outcome of acute ischemic stroke (AIS). Methods 189 patients with AIS were included. Serum Hs-CRP, HCY levels and National Institute of Health Stroke Scale (NIHSS) were assessed after admission. Short- term functional outcome was measured by modified Rankin Scale (mRS) 90 d after admission. Results The serum Hs-CRP and HCY levels were significantly higher in AIS patients than in normal controls (P<0.001). Adjusting age and the NIHSS score, Hs-CRP and HCY were independent prognostic markers of functional outcome and death in patients with AIS. In receiver operating characteristic curve (ROC) analysis, the prognostic accuracy of combined model (HCY and Hs-CRP) was higher than that of biomarkers measured alone and the NIHSS score. Conclusion Hs-CRP and HCY are independent predictors of short-term outcome and mortality after AIS. Combined model may provide additional general prognostic information.