缺血性脑卒中患者C-反应蛋白含量测定的临床意义

目的　探讨C -反应蛋白 (C -reactiveprotein ,CRP)与缺血性脑卒中的关系。方法　测定 42例急性缺血性脑卒中早期血浆CRP水平。结果　病变组CRP水平高于正常组 (4 2 8± 2 76)mg/L ,VS(2 0 4± 1 48)mg/L(P <0 0 1)。结论　CRP与缺血性脑卒中密切相关。     

血清超敏C-反应蛋白与老年急性缺血性脑卒中的关系

目的　探讨和研究血清高敏 C-反应蛋白(high-sensitivity C-reactive protein hsCRP)与老年急性缺血性脑卒中(AIS)的关系及其可能机制。方法　对 72 例老年 AIS患者和 56 例健康查体者,检测血浆hsCRP水平,以多项临床及生化指标为危险因素进行统计学分析。结果　老年 AIS组的hsCRP水平(4.68±3.16)mg/L明显高于对照组(1.65±1.89) mg/L,差异具有显著性意义。单因素Logistic回归分析,发现hsCRP是AIS发生的一个独立危险因素,高 hsCRP(≥1.5 mg/L)发生 AIS的OR值为6.9。且随hsCRP水平的增高,AIS临床病情严重程度增加。年龄、BMI、总胆固醇、HDL-C以及临床病情严重程度与hsCRP显著相关,但校正年龄和BMI后,只有临床病情严重程度与hsCRP仍保持显著相关。结论　老年AIS患者的体内炎症反应水平是升高的,hsCRP是老年 AIS患者临床病情严重程度的一个敏感指标。     

血清超敏C-反应蛋白与老年急性缺血性脑卒中的关系

研究表明,血清C-反应蛋白(C-reactiveprotein,CRP)参与动脉粥样硬化(AIS)的发生、发展,其含量增高是发生AIS的一项独立危险因子,且与缺血性脑卒中病情进展密切相关,是缺血性脑卒中预后的重要预测因子。本研究对72例老年AIS患者和56例健康查体者,检测血浆高敏C反应蛋白(hsCRP)水平以及多项临床及生化指标为危险因素进行分析比较。1资料与方法患者组:男40例,女32例,年龄60～85岁,平均66±5.2岁;对照组:男36例,女20例,年龄60～72岁,平均64.8±4.7岁。所有患者均发病24h内入院,并排除自身免疫性疾病、恶性肿瘤、近期内有急慢性感染、凝…     

急性缺血性脑卒中血清C反应蛋白含量与预后的相关性分析

目的 探讨急性缺血性脑卒中患者早期血清CRP水平与其预后的关系.方法 采用免疫透射比浊法测定2组血清CRP的含量,观察组按CRP结果＜5 mg/L、5～12 mg/L、＞12 mg/L分为3组.对每位患者进行神经功能缺损程度采用美国国立卫生研究院卒中量表(NIHHS)评分,在患者入院时及治疗后2周分别进行评分,并进行对...     

缺血性脑卒中患者急性期C反应蛋白水平与病情及预后的相关性分析

目的 探讨缺血性脑卒中患者急性期C反应蛋白（CRP）水平与病情严重程度、颓后的相关性。方法 对符合入选标准的75例缺血性脑卒中患者,在发病后24h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,所有患者行CT或MRI检查,在出院时对预后进行评定。结果 CRP异常组脑梗死28例,明显高于腔隙性梗死13例;CRP异常组患者CNFDS评分较高,中位数为17（5-34）,且预后不良。结论 缺血性脑卒中患者急性期C反应蛋白水平可作为反映脑卒中病情严重程度及预后的一个重要指标。     

急性缺血性脑卒中与炎症反应

炎症反应是急性缺血性脑卒中发病的一个重要危险因素 ,引起炎症的主要原因是肺衣原体、幽门螺杆菌或其它细菌、病毒感染。炎症反应的一个重要生化指标是C -反应蛋白水平升高 ,根据炎症的不同病因使用相应的抗生素、阿斯匹林和 /或进行规律性耐力锻炼 ,可降低C -反应蛋白水平、终止或减轻炎症反应损害 ,从而降低急性脑卒中的发病危险。     

血清同型半胱氨酸和超敏C-反应蛋白与缺血性进展性脑卒中的相关研究

目的研究血清同型半胱氨酸（Hcy）与超敏C-反应蛋白（hs-CRP）在缺血性进展性脑卒中中的作用。方法对76例缺血性进展性脑卒中和80例完全性脑卒中患者的血清同型半胱氨酸和超敏C-反应蛋白水平进行测定,比较2组血清同型半胱氨酸和超敏C-反应蛋白水平。结果缺血性进展性脑卒中患者血清同型半胱氨酸和超敏C-反应蛋白水平显著高于同时期完全性脑卒中患者。结论缺血性进展性脑卒中的发生与血清同型半胱氨酸和超敏C-反应蛋白的水平有关系,血清同型半胱氨酸和超敏C-反应蛋白可作为预测及评价缺血性进展性脑卒中的重要指标之一。     

急性脑梗死患者C-反应蛋白水平变化

目的探讨脑梗死患者血浆中C反应蛋白(CRP)的变化规律。方法采用免疫比浊法测定50例脑梗死患者起病1周内、4周时血浆CRP浓度;入院第2d空腹血糖和血脂浓度,并与对照组进行比较,同时把脑梗死患者入院当天按神经功能缺损评分分为轻型组、中型组和重型组3组。结果脑梗死患者起病1周内的CRP浓度明显升高(P<0.01),第4周时CRP浓度有所下降但仍高于正常(P<0.05),中、重2组与轻组比较1周内和4周时的CRP浓度有显著性差异(P<0.01),重型与中型比较CRP浓度也有明显差异(P<0.01);不管是脑梗死组还是对照组50岁以下组和50岁以上组CRP浓度比较无明显差异(P>0.05),合并糖尿病组其CRP和血糖浓度明显高于不合并糖尿病组(P<0.05)。结论CRP参与了脑梗死的炎症反应的病理生理过程,并且病情越重,CRP浓度越高,CRP浓度与年龄无明显关系;脑梗死合并糖尿病时双重作用使CRP升高。     

C反应蛋白与缺血性脑卒中的病情预测

目的　探讨急性缺血性脑卒中患者的血浆CRP水平变化与其病情之间关系。方法　测定 2 0 6例急性缺血性脑卒中早期血浆CRP水平及相关指标。结果　病人组血浆CRP水平平均 (10 0 4± 2 1 83mg/L) ,显著高于正常对照组 (1 4 8± 1 80mg/L) ,P <0 0 1。CRP较高组起病较急、病情重、住院时间较长 ,合并冠心病、空服血糖、总胆固醇比例高 ,P <0 0 5。结论　监测血浆CRP对缺血性卒中病情有预测作用。     

Wide-range C-reactive protein efficacy in acute ischemic stroke patients

OBJECTIVE: To compare the recently introduced wide-range C-reactive protein (wr-CRP) with the widely used high-sensitivity Behring Dade method (hs-CRP) in acute stroke/transient ischemic attack (TIA) patients. MATERIALS AND METHODS: A total of 119 consecutive patients admitted to a tertiary medical center with acute ischemic stroke/TIA were included in the study. Venous blood was obtained for both assays during the first 24 h, 3-5 days, as well as 3-6 months thereafter. RESULTS: A highly significant correlation (r=0.994, P<0.0001) was found between the two methods even when analyzed at three different time points. In addition, a similar correlation was noted between these two assays and other commonly used biomarkers, including white blood cell count, Westergren's sedimentation rate and quantitative fibrinogen. CONCLUSION: Real-time, on-line and low-cost wr-CRP assay is a reasonable alternative to the Behring Dade hs-CRP method in acute stroke/TIA patients.     

Prognostic value of serum thioredoxin levels in ischemic stroke

Objectives: Thioredoxin (Trx) is one of significant antioxidative molecules to diminish oxidative stress. Current evidence suggests that Trx is a potent antioxidant with cytoprotective functions. The aim of our study was to investigate specifically the association between serum Trx levels and acute ischemic stroke (AIS) patients.

Methods: 198 AIS patients and 75 controls were enrolled to the study. Serum Trx levels were measured using an enzyme-linked immunosorbent assay (ELISA). Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS) score on admission. Clinical endpoint was functional outcome measured by Barthel Index (BI) 3 months after admission. Multivariate binary logistic regression analyses were performed to identify predictors.

Results: We found that serum Trx levels were significantly increased in patients as compared to controls. Serum Trx was an independent biomarker to predict ischemic stroke (OR, 1.264; 95% CI, 1.04–1.537; P = 0.019). In addition, there was a negative correlation between NIHSS score at admission and serum Trx levels in cardioembolic stroke patients (r = ?0.422; P = 0.013). Furthermore, higher serum Trx levels in AIS patients were associated with favorable functional outcome. Serum Trx was an independent predictor for the functional outcome (OR, 0.862; 95% CI, 0.75–0.991; P = 0.037).

Conclusions: Serum Trx might be as a biomarker of cardioembolic stroke severity. Increased serum Trx levels could be a useful tool to predict good prognosis in patients with AIS.     

首次脑梗死患者和正常健康者血清超敏C-反应蛋白的性别差异及其意义

目的探讨首次脑梗死患者与正常健康体检者血清超敏C-反应蛋白(hsCRP)的性别差异及意义。方法选取1 3 8例首次脑梗死患者(NIHSS评分<5分)作为脑梗死组,将其分为男性组和女性组。选取1 5 0例健康体检者作为正常组,亦分为男性组和女性组。检测各组患者血清hsCRP水平。结果脑梗死组血清hsCRP水平明显高于正常组(P<0.05)。男性脑梗死组与女性脑梗死组血清hsCRP相比较差异无统计学意义(P>0.0 5)。男性正常组与女性正常组血清hsCRP相比较,男性组高于女性组,差异有统计学意义(P<0.0 5)。男性脑梗死组与男性正常组血清hsCRP相比较差异无统计学意义(P>0.0 5)。女性脑梗死组与女性正常组血清hsCRP相比较差异有统计学意义(P<0.0 5)。结论血清hsCRP水平存在性别差异。炎症反应与女性脑梗死的发病可能有着更为密切的联系。     

Predictors of outcome after acute ischemic stroke

The aim of this study was to determine which variables should be the predictors for clinical outcome at discharge and sixth month after acute ischemic stroke. METHODS: Two hundred and sixty-six consecutive patients, each with an acute ischemic cerebrovascular disease, were evaluated within 24 h of symptom onset. We divided our patients into two groups; 1 - Independent (Rankin scale RS < or = 2) and, 2 - Dependent (RS>3) and death. Baseline characteristics, clinical variables, risk factors, infarct subtypes and radiologic parameters were analyzed. RESULTS: Canadian Neurological Scale (CNS) on admission <6.5 [odds ratio (OR) 22] and posterior circulation infarction (OR 4.2) were associated with a poor outcome at discharge from hospital whereas only a CNS score <6.5 (OR 14) was associated with a poor outcome at 6 months. CONCLUSIONS: Severity of neurologic deficit is the most important indicator for clinical outcome in acute ischemic stroke both at short-term and at sixth month, whereas posterior circulation infarction also predicts a poor outcome at discharge.     

Combination of high-sensitivity C-reactive protein and homocysteine predicts the short-term outcomes of Chinese patients with acute ischemic stroke

Abstract

Background: Ischemic stroke is one of the most common causes of death worldwide. Early and accurate prediction of outcome in acute ischemic stroke (AIS) is important and influences risk-optimized therapeutic strategies. We investigated the changes in high-sensitivity C-reactive protein (Hs-CRP) and homocysteine (HCY) levels, two of the risk factors, during the acute period of AIS and evaluated the relationship between these levels and short-term prognosis.

Methods: We prospectively studied 189 patients with AIS who were admitted within 24 hours after the onset of symptoms. Serum Hs-CRP, HCY levels, and National Institutes of Health Stroke Scale (NIHSS) were measured at the time of admission. Short-term functional outcome was measured by the modified Rankin scale (mRS), 90 days after admission.

Results: The median serum Hs-CRP and HCY levels were significantly higher in AIS patients as compared to normal controls (P < 0·0001, respectively). High-sensitivity C-reactive protein and HCY were independent prognostic markers of functional outcome and death (adjusted for age and the NIHSS) in patients with AIS. In receiver operating characteristic curve analysis, the prognostic accuracy of the combined model (HCY and Hs-CRP) was higher compared to all measured biomarkers individually and the NIHSS score.

Conclusion: High-sensitivity C-reactive protein and HCY are independent predictors of short-term outcome and mortality after AIS. The combined model may provide additional general prognostic information.     

脑梗死急性期超敏C反应蛋白水平与神经功能恢复的关系

目的探讨脑梗死急性期超敏C反应蛋白（hs-CRP）水平与脑梗死神经功能恢复的关系。方法选取发病72h内的急性脑梗死患者269例,入院第2天测定hs-CRP,按hs-CRP水平分为低hs-CRP组（hs-CRP≤3mg/L）及高hs-CRP组（hs-CRP〉3mg/L）,比较2组患者的临床资料,分析影响hs-CRP水平的因素;入选患者进行90d随访,比较2组患者90d时神经功能恢复情况（改良Rankin量表评分3～6分为恢复不良）,分析影响神经功能恢复的因素。结果 共266例患者完成随访,hs-CRP中位数3.15mg/L（1.12～8.89mg/L）。高hs-CRP组（138例）年龄较大（P〈0.001）,糖尿病发病率较高（P=0.001）,房颤发病率较高（P=0.004）,入院时脑梗死较严重（P=0.003）;高龄、合并糖尿病及房颤、入院时脑梗死严重程度与hs-CRP水平高独立相关（P均〈0.05）;高hs-CRP组神经功能恢复不良比例高于低hs-CRP组（P〈0.001）;hs-CRP升高与神经功能恢复不良独立相关（OR1.213,P=0.001,Logistic分析）。结论 高龄、糖尿病史、房颤病史、脑梗死严重程度重可能是hs-CRP升高的独立危险因素;hs-CRP升高可能是神经功能恢复不良的独立危险因素。     

C-reactive protein and long-term ischemic stroke prognosis

C-reactive protein (CRP) is an inflammatory biomarker of inflammation and may reflect progression of vascular disease. Conflicting evidence suggests CRP may be a prognostic biomarker of ischemic stroke outcome. Most studies that have examined the relationship between CRP and ischemic stroke outcome have used mortality or subsequent vascular event as the primary outcome measure. Given that nearly half of stroke patients experience moderate to severe functional impairments, using a biomarker like CRP to predict functional recovery rather than mortality may have clinical utility for guiding acute stroke treatments. The primary aim of this study was to systematically and critically review the relationship between CRP and long-term functional outcome in ischemic stroke patients to evaluate the current state of the literature. PubMed and MEDLINE databases were searched for original studies which assessed the relationship between acute CRP levels measured within 24 hours of symptom onset and long-term functional outcome. The search yielded articles published between 1989 and 2012. Included studies used neuroimaging to confirm ischemic stroke diagnosis, high-sensitivity CRP assay, and a functional outcome scale to assess prognosis beyond 30 days after stroke. Study quality was assessed using the REMARK recommendations. Five studies met all inclusion criteria. Results indicate a significant association between elevated baseline high sensitivity CRP and unfavorable long-term functional outcome. Our results emphasize the need for additional research to characterize the relationship between acute inflammatory markers and long-term functional outcome using well-defined diagnostic criteria. Additional studies are warranted to prospectively examine the relationship between high sensitivity CRP measures and long-term outcome.