急性脑梗死患者血胆红素、高敏C反应蛋白和同型半胱氨酸的表达及其临床意义

目的观察血胆红素、高敏C反应蛋白（hs—CRP）和同型半胱氨酸（Hcy）在急性脑梗死患者中的表达，并分析其临床意义。方法选择2011年1月～2012年12月上海市第一人民医院宝山分院收治的急性脑梗死患者198例，按照神经功能缺损评分标准分为轻型（0～15分）82例，中型（16～30分）61例，重型（31～45分）55例，选取同期颈动脉粥样硬化（AS）的体检者30例为对照组。分析两组胆红素、hs—CRP和Hey水平变化．观察胆红素、hs—CRP和Hcy水平与急性脑梗死严重程度的关系。结果急性脑梗死组hs—CRP[（14．82±1．93）mg／L1和Hey[（23．76±8．59）μmol／L]水平较对照组[（1．24±0．47）mg／L、（7．23±3．82）μmol／L]明显升高，差异有高度统计学意义（P〈0．01）；急性脑梗死组TBIL[（11．91±3．82）μmol／L]和IBIL[（6．54±1．26）μmol／L]水平较对照组[（15．53±2．18）、（9．95±2．98）μmol／L]明显降低，差异有高度统计学意义（P〈0．01）；两组的DBIL水平差异无统计学意义（P〉0．05）。重型组患者hs—CRP和Hcy水平[（18．04±2．27）mg／L、（27．73±8．03）mg／L1高于中型组[（14．93±2．02）mg／L、（24．06±8．63）μmol／L]和轻型组[（12．58±1．18）mg／L、（20．87±7．52）μmol／L]患者，中型组hs—CRP和Hcy水平高于轻型组患者，差异有统计学意义（P〈0．05或P〈0．01）；重型组患者TBIL和IBIL水平f（8．97±2．08）、（3．64±3．29）Wmol／L]低于中型组[（10．87±2．37）mg／L、（5．51±2．87）μmol／L]和轻型组[（14．65±3．98）mg／L、（9．25±2．25）μmol／L]患者，中型组TBIL和IBIL水平低于轻型组患者，差异均有统计学意义（P〈0．05或P〈0．01）；各组DBIL水平差异无统计学意义（P〉0．05）。结论胆红素、hs—CRP和Hcy水平参与了急性脑梗死疾病发生发展，急性脑梗死的严重程度与血胆红素、hs—CRP和Hey水平有关。

Expression and clinical significance of blood bilirubin,high-sensitivity C- reactive protein and homocysteine in patients with acute cerebral infarction

Objective To observe the expression of blood bilirubin, high-sensitive C-reactive protein （hs-CRP） and homocysteine （Hcy） in patients with acute cerebral infarction, and to analyze its clinical significance. Methods 198 patients with acute cerebral infarction in Baoshan Branch of Shanghai First People＇s Hospital from January 2011 to December 2012 were selected as acute cerebral infarction group and divided into light group （82 cases, 0-15 points）, medium group （61 cases, 16-30 points） and heavy group （55 cases, 31-45 points） according to the neurological deficit score. 30 physical examination ones with carotid atherosclerosis at the same period were selected as control group. The levels of bilirubin, hs-CRP and Hcy were analyzed in two groups, and the relationship between the levels of hs-CRP and Hcy and severity of acute cerebral infarction were observed. Results The levels of hs-CRP and Hcy in acute cerebral infarction group [（14.82±1.93） mg/L, （23.76±8.59） μmol/L] were all higher than those in control group[（1.24±0.47） mg/L, （7.23±3.82） μmol/L], the differences were statistically significant （P 〈 0.01）; the levels of TBIL and IBIL in acute cerebral infarction group [（11.91±3.82） μmol/L, （6.54±1.26） μmol/L] were all lower than those in control group [（15.53±2.18）, （9.95±2.98） μmol/L], the differences were statistically significant （P 〈 0.01）; the difference of DBIL level in the two groups was not statistically significant （P 〉 0.05）. The levels of hs-CRP and Hey in heavy group [（18.04± 2.27） mg/L, （27.73±8.03） mg/L] were all higher than those in medium group [（14.93±2.02） mg/L, （24.06±8.63） μmol/L] and light group [（12.58±1.18） mg/L, （20.87±7.52） μmol/L], levels of hs-CRP and Hcy in medium group were all higher than those in light group, the differences were statistically significant （P 〈 0.05 or P 〈 0.01）; the levels of TBIL and IBIL in heavy group [（8.97±2.08）, （3.64±3.29） μmol/L] were all lower than those in medium group [（10.87±2.37） mg/L, （5.51±2.87） μmol/L] and light group [（14.65±3.98） mg/L, （9.25±2.25） μmol/L], levels of TBIL and IBIL in medium group were all higher than those in light group, the differences were statistically significant （P 〈 0.05 or P 〈 0.01）, the differences of levels of DBIL in every group were not statistically significant （P 〉 0.05）. Conclusion The bilirubin, hs- CRP and Hey levels participate in the development of acute cerebral infarction disease, and the severity of acute cerebral infarction have correlation with bilirubin, hs-CRP and Hcy levels.