C反应蛋白与急性脑梗死的预后及并发多脏器功能障碍综合征的相关性

目的探讨急性脑梗死(ACI)及并发多脏器功能障碍综合征(MODS)时C反应蛋白的变化,评估C反应蛋白在ACI的预后及并发MODS中的临床价值.方法采用免疫透射比浊法测定30例体检健康者(对照组)和82例ACI患者(ACI组)出现首发症状7天以内血清CRP的含量,其中腔隙性脑梗死20例(LCI)组,ACI并发MODS患者(MODS)组32例,急性脑梗死30例(SACI组,即非LCI并且未并发多脏器功能障碍综合征).结果 (1)30例健康者全部CRP＜10 mg/L,ACI组CRP＞10 mg/L的阳性率达97.5%;(2)SACI组及MODS组CRP水平与LCI组比较差异显著(P＜0.05),MODS组CRP水平较SACI组明显增高;(3)血清CRP＜30mg/L时,MODS的发生率为0,血清CRP水平＞30mg/L时,随着CRP水平的升高,ACI发生MODS的发生率逐渐增高.结论血清CRP水平与病情的严重程度和MODS的发生率呈正相关,CRP是判断ACI预后和并发MODS的一个有效实验指标.

Clinical significance of C-reactive protein in patients with acute cerebral infarction

Objective To investigate the alteration plasma concentration of C-reactive protein (CRP) in patients with acute cerebral infarction (ACI)and ACI with multiple organ dysfunction syndrome(MODS) and to assess the clinical value of CRP in the prognosis of ACI with MODS.Methods The plasma CRP levels of 30 normal healthy people(normal controls) and 82 patients (ACI group) admitted to hospital 7 days of a first symptom of acute cerebral infarction were determined by immune transmission turbidity method. Twenty cases were lacunar cerebral infarction (LCI) group and 32 cases were ACI and MODS (MODS group). Thirty cases were acute simple cerebral infarction (SACI group, not lacunar cerebral infarction and without multiple organ dysfunction syndrome).Results (1) The levels of plasma CRP in cases of normal healthy people were all under 10 mg/L. In ACI group, the high CRP level(>10 mg/L) may reach 97.5%; (2) The level of plasma CRP in patients with SACI and MODS groups increased significantly compared with that of normal control group (P< 0.05). The level of plasma CRP in patients with MODS group increased significantly compared with that of SACI team (P< 0.05); (3) When the level of CRP is under 30 mg/L, the incidence of MODS in patients with ACI was zero. When the level of CRP is higher than 30 mg/L, the incidence of MODS increased gradually with the rise of level of CRP. There is the positive correlation between the incidence of MODS and CRP level in patients with ACI.Conclusions There is the positive correlation among the plasma level of CRP severity extent of ACI and the invidence of MODS. CRP is a useful experiment marker in predicting the prognosis of ACI and MODS.