不同亚型卒中患者血清高敏C反应蛋白水平及其意义

目的 探讨不同亚型急性缺血性卒中(AIS)患者血清高敏C反应蛋白(hs-CRP)水平的变化及其意义.方法 124例AIS患者按照低分子肝素试验(TOAST)标准进行病因学分型:大动脉粥样硬化(LAA)型47例,小动脉闭塞(SVO)型37例,心源性栓塞(CE)型21例,其他明确原因(ODE)型和原因不明(UE)型19例.患者于入院第2天(发病后72 h内)、第7天和第14天分别抽血检测hs-CRP水平,并与81例健康体检者(对照组)进行比较.结果 LAA型患者发病后72 h内、发病后1周、发病后2周时血清hs-CRP水平分别为(10.77±4.27)、(16.41±5.61)、(7.63±3.59)mg/L;SVO型分别为(3.99±1.56)、(6.45±3.25)、(4.22±3.21)mg/L;CE型分别为(11.60±4.85)、(25.14±7.12)、(9.24±4.61)nag]L;ODE及UE型分别为(6.09±2.43)、(9.65±4.65)、(5.89±2.68)mg/L.除SVO型血清hs-CRP水平与对照组(4.26±1.34)mg/L比较差异无统计学意义外,其余各型不均明显高于对照组;而且除SVO型不同时间血清hs-CRP水平比较差异无统计学意义(P>0.05)外,其他各型同时间血清hs-CRP水平比较差异均有统计学意义(P<0.05).结论 AIS患者血清hs-CRP水平增高,与疾病严重程度呈正相关,从TOAST各亚型变化不同表现出来,并随发病后的时间而变化.提示炎性反应可能在AIS的病理机制中起重要作用.

The levels of serum highsensitive C-reactive protein in different subtypes of stroke and its significance

Objective To explore, the levels of serum highsensitive C-reactive protein (hs-CRP) in different subtypes of acute ischemic stroke (AIS) and its significance. Methods According to TOAST criteria, 124 cases of AIS were divided into four groups: large-artery atherosclerosis (LAA,47 cases), small-artery occlusion (SVO,37 cases), cardiogenic cerebral embolism (CE,21 cases), acute stroke of other determined etiology and stroke of other undetermined etiology (ODE and UE, 19 cases). The serum concentration of hs-CRP was measured with the immunoturbidimetry in every patient of each group at 72 hours, 7 and 14 days after admitted to hospital. Meanwhile 81 healthy persons were involved in control group. Results The serum concentrations of hs-CRP at 72 hours, 7 and 14 days after onset were (10.77 ± 4.27),(16.41±5.61), (7.63±3.59) mg/L in LAA group;(3.99± 1.56), (6.45±3.25), (4.22±3.21) mg/L in SVO group; (11.60±4.85), (25.14±7.12), (9.24±4.61) mg/L in CE group; (6.09±2.43), (9.65 ±4.65), (5.89 ± 2.68) mg/L in ODE and UE group. The serum concentrations of hs-CRP in LAA group, CE group, ODE and UE group were significantly higher than those in control group (4.26 ± 1.34) mg/L] (P <0.05) except for that in SVO group, the level of serum hs-CRP in the three groups showed significant difference among the different time (P< 0.05). Conclusions The level of serum hs-CRP in AIS patients is increased and positively correlated with the disease severity. The changes of hs-CRP level are performed in various subtypes of TOAST, and show time-dependent effects. Inflammatory response may play an important role in the pathological mechanism of AIS.