C-反应蛋白水平对急性缺血性脑卒中预后影响的系统评价

目的 应用Meta分析,评价C-反应蛋白(C-reactive protein,CRP)水平对急性缺血性脑卒中预后的影响.方法 计算机检索PubMed、MEDLINE(1991-2006)、中国学术期刊全文数据库(1979-2006)等.搜集CRP水平对急性缺血性脑卒中预后影响非随机对照研究,逐篇评价纳入文献的质量,采用RevMan4.2版软件进行Meta分析.结果 共纳入7篇文献(外文4篇,中文3篇),涉及841例患者.在急性缺血性脑卒中患者中,3个月以上随访截尾时间的死亡率和再发血管事件与CRP水平相关,CRP增高组发生率比CRP正常组分别高2.71和1.81倍OR合并分别为3.71和2.81,95%CI分别为(2.40,5.73)和(1.42,5.53)]均有统计学意义(P＜0.05);CRP测量值与缺血性脑卒中复发和死亡亦相关,在复发患者中,CRP测量值平均高于未复发者为3.52 mg/LWMD=3.52,95%CI(-0.01,7.05)],具有一定的临床意义;在死亡患者中,CRP测量值平均高于生存者为8.02 mg/LWMD=8.02,95%CI(5.68,10.37)],具有统计学意义(P＜0.05).结论 发病时CRP的水平可以初步评价急性缺血性脑卒中患者的预后.

Prognostic influence of C-reactive protein levels on acute ischemic stroke:a systematic review

Objective To study the effects of C-reactive protein (CRP) level on the prognosis of patients with acute ischemic stroke through Meta-analysis.Methods The related papers were retrieved in PubMed, MEDLINE (1991-2006), EMBASE(1989-2006), Chinese Journals Full-text Database (1979-2006), Weipu Database (1989-2006), Chinese Biological Medical Database (CBM-disk, 1978-2006) and Chinese Important Conference Thesis Full-text Database (1999-2006) by computer. The methodological quality of these papers was evaluated and the meta-analysis was performed by RevMan 4.2 software.Results Seven papers including four English papers and three Chinese papers were adopted and 841 patients met the selection criteria. Meta-analysis results showed that higher CRP level was associated with mortality and mobility of new vascular event. The mortality and mobility of the higher CRP group were 2.71 times and 1.81 times more than those of the normal CRP group (OR= 3.71 and 2.81, 95%CI: 2.40-5.73 and 1.42- 5.53). The level of CRP was associated with death and relapse of stroke. The average level of CRP in the relapsed cases were 3.52 mg/L more than those who had not relapse WMD=3.52, 95%CI (-0.01, 7.05)]. In the dead cases, the average level of CRP was 8.02 mg/L more than that in the surviors WMD=8.02, 95%CI (5.68, 10.37), P<0.05].Conclusions The level of CRP may be used to evaluate the prognosis of patients with acute ischemic stroke.