不同病因和发病机制首次急性缺血性卒中患者超敏C反应蛋白的变化

目的 观察首发急性缺血性卒中不同病因和发病机制患者发病早期血清超敏C反应蛋白（high sensitivity C-reactive protein，hs-CRP）水平变化，探讨其在缺血性卒中患者中的临床意义。方法 采用免疫比浊法对423例首发住院缺血性卒中患者发病7 d内血清hs-CRP水平进行测定，按照中国缺血性卒中亚型（Chinese Ischemic Stroke Subclassification，CISS）标准对患者进行病因及发病机制分型，并进行对照分析。结果 在不同病因中，心源性卒中组hs-CRP水平最高［（8.09±4.47）mg/L］，其次依次为大动脉粥样硬化组［（5.89±4.02）mg/L］、其他病因组［（5.21±4.64）mg/L］、穿支动脉疾病组［（3.67±3.47）mg/L］、病因不明确组［（2.83±4.40）mg/L］，组间比较差异有显著性（F=7.905，P=0.015）；大动脉粥样硬化病因中发病机制不同，hs-CRP水平亦不相同，由高到低依次为：动脉-动脉栓塞组［（7.88±3.35）mg/L］、混合机制组［（5.88±3.50）mg/L］、低灌注/栓子清除下降组［（5.15±4.36）mg/L］、载体动脉（斑块或血栓）阻塞穿支动脉组［（4.47±3.88）mg/L］，组间比较差异有显著性（F=15.821，P=0.013）。结论 首发急性缺血性卒中患者不同CISS亚型hs-CRP水平差异具有显著性

Changes of High Sensitivity C-reactive Protein Level in the First Acute Cerebral Infarction Patients with Diffierent Etiology and Pathophysiology

Objective To investigate the regularity and clinical significance of high serum sensitivity C-reactive protein(hs-CRP) level in the first early acute cerebral infarction(ACI) patients with the different etiology and pathophysiology.
Methods Four hundred and twenty-three patients were divided in accordance with the etiology and pathophysiology of Chinese Ischemic Stroke Subclassification(CISS). Serum hs-CRP levels within 7 days were detected and analysed by immune turbidimetry.
Results In the different causes, cardiogenic stroke group has the highest hs-CRP level([8.09±4.47]mg/L), followed by the order of large artery atherosclerosis group([5.89±4.02]mg/L, other etiology group[5.21±4.64]mg/L), penetrating artery disease group([3.67±3.47]mg/L) and undetermined etiology group([2.83±4.40]mg/L), hs-CRP level of each group was significant different(F=7.905; P=0.015); The pathophysiology of thrombosis is different, hs-CRP level is not the same, order as follows:artery-to-artery embolism group([7.88±3.35]mg/L), multiple mechanisms group([5.88±3.50]mg/L), hypoperfusion/emboli clearance group([5.15±4.36]mg/L, penetrating artery group[4.48±3.88]mg/L), hs-CRP level of each group was significant different(F=15.821; P=0.013).
Conclusion Hs-CRP levels were significant different in the first early acute cerebral infarction patients with the different etiology and pathophysiology.