C反应蛋白--缺血性脑卒中预后的重要标志物

目的　研究C反应蛋白 (CRP)水平与脑梗死灶体积、颈动脉斑块及脑卒中预后的关系。方法　对纳入研究的 12 1例缺血性脑卒中患者在发病后 72h内抽取血清测定CRP水平 ,按脑卒中患者临床神经功能缺损程度评分标准 (CNFDS)进行评分 ,所有患者进行CT/MRI及颈动脉超声检查。结果　CRP异常组患者入院时血糖水平为 ( 8 0 6± 5 47)mg/L ,白细胞数为 ( 10± 4)× 10 9/L ,明显高于CRP正常组的 ( 6 43± 2 78)mg/L和 ( 9± 3)× 10 9/L ;脑梗死发生率 ( 42例 )明显高于腔隙性脑梗死 ( 2 3例 ) ;颈动脉斑块的发生率也较CRP正常组高 ( 32例 ,17例 )。CRP的异常组患者CNFDS评分较高 ,中位数为 18( 6～ 35 ) ,且预后不良。结论　CRP水平是反映颈动脉斑块及脑卒中患者预后的一个重要标志物。

C-reactive protein as an important prognostic marker for ischemic stroke

Objective There is growing evidence indicating that reactions of inflammatory system play an important role in stroke and development of carotid plaques. It is purposed to understand the relationship between serum level of c-reactive protein (CPR) and size of cerebral infarction, carotid plaques and prognosis of ischemic stroke. Methods A total of 121 patients with ischemic stroke were included in the study. Serum level of CRP was measured within 72 hours after onset of index stroke. All patients were scored by CNDF based on deficit in their clinical neurological function, and examined with CT/MRI and carotid duplex ultrasound scanning. Results Leukocyte count and blood glucose level at admission were significantly higher in the group with abnormal serum level of CRP than those with normal one (P=0.045 andP=0.021, respectively). Incidence of territory infarction (42 cases, 61.76%) was also significantly higher than that of lacunar infarction (23 cases, 43.4%), withP=0.044. Occurrence of carotid plaques was higher in the former (32 cases, 65.30%) than that in the latter (17 cases, 34.69%), withP=0.035. CNFD scores were higher in the former (ranging 6-35, with a median of 18) than those in the latter (ranging 6-28, with a median of 11), with Mann-Whitney U test,P= 0.000 1. And, more severe prognosis was also found in the former than in the latter, with P=0.000 1.Conclusion Serum level of CRP was an important prognostic marker for carotid plaque and stroke.