血清超敏C反应蛋白与急性脑梗死及其神经功能缺损程度之间的关系

目的：探讨急性脑梗死（ACI）患者血清超敏 C 反应蛋白（hs-CRP）水平的变化及其与 ACI严重程度及不同病因分型的关系。方法检测256例 ACI 患者和196名健康查体者的血清 hs-CRP，对ACI 患者进行美国国立卫生研究院卒中量表（ NIHSS）评分和病因分型（CISS 分型），比较不同 NIHSS 评分和 CISS 分型患者的血清 hs-CRP 水平。对 ACI 危险因素进行 Logistic 回归分析，观察各危险因素与ACI 的相关性。结果 ACI 患者血清 hs-CRP 为（4.69±2.58）mmol/ L，健康对照组血清 hs-CRP 为（2.13±1.79）mmol/ L，两组之间比较差异有统计学意义（t =12.439，P =0.000）。中重型 ACI 患者147例，血清 hs-CRP 为（5.89±4.15）mmol/ L，轻型患者109例，血清 hs-CRP 为（2.11±1.45）mmol/ L，两组之间比较差异有统计学意义（t =10.230，P =0.000）。ACI 各病因亚型中大动脉粥样硬化型106例（41.57％）， hs-CRP 水平最高，为（7.01±3.12）mmol/ L，与健康对照组相比，差异有统计学意义（ P =0.000）。经Logistic 回归分析，总胆固醇、同型半胱氨酸及 hs-CRP 与 ACI 呈正相关（ OR 值分别为0.324、0.749、0.809，P 均＜0.05）。结论 ACI 患者 hs-CRP 水平明显增高，且与神经功能缺损程度有关，动脉粥样硬化型 hs-CRP 水平最高，观察血清 hs-CRP 的水平变化对判断 ACI 患者的病情严重程度具有重要的意义。

Relation between serum high sensitive C-reactive protein and acute cerebral infarction and its degree of nervous function defect

Objective To investigate the changes of serum high sensitive C-reactive protein（hs-CRP） level in patients with acute cerebral infarction（ACI）,and the relationship between serum hs-CRP level and ACI severity as well as subtypes according to Chinese Ischemic Stroke Subclassification（CISS）criteria. Methods The serum hs-CRP level in 256 patients with ACI and 196 normal controls were measured. The degree of nervous function defect in patients with ACI was assessed by the United States National Institutes of Health Stroke Scale （ NIHSS ） score. All patients were classified into five major ischemic stroke subtypes based on CISS criteria. Logistic regression analysis was applied to analyze the risk factors of ACI. Results The serum hs-CRP level in patients with ACI and control group were（4. 69 ± 2. 58）mmol/ L and（2. 13 ± 1. 79）mmol/ L,and the difference between groups was significant（t = 12. 439,P = 0. 000）. The hs-CRP in patients with severity ACI （147 cases）were（5. 89 ± 4. 15）mmol/ L,significantly higher than that in patients with mild ACI,and the difference between groups was significant（（2. 11 ± 1. 45）mmol/ L,t = 10. 230,P = 0. 000））. As for subtype ACI,the case of the large artery atherosclerosis subtypes was 106（ 41. 57% ）,highest than any other subtypes. The hs-CRP level of large artery atherosclerosis was（7. 01 ± 3. 12）mmol/ L,higher than that of control group（ P = 0. 000）. The logistic regression analysis showed that many factors were related to ACI including total cholesterol,homocysteine and high sensitive C-reactive protein（ OR = 0. 324,0. 749,0. 809;P〈 0. 05）. Conclusion The serum hs-CRP level in patients with ACI increase significantly,and relate to the degree of neural function defect. The level of hs-CRP of large artery atherosclerotic stroke is the highest. The change of serum hs-CRP is very valuable to estimate the severity of ACI.