不同类型脑梗死患者血清C反应蛋白水平的变化及临床意义

目的观察C反应蛋白(CRP)水平在不同类型急性脑梗死(ACI)患者血清中的变化规律,探讨其在ACI患者中的临床意义。方法采用酶联免疫吸附法对我院166例住院患者(发病1周内)进行CRP水平的测定,按TOAST分型分大动脉粥样硬化性脑梗死(LAA)组46例,小动脉闭塞性脑梗死(SAO)组40例,心源性脑梗死(CE)组20例,其他病因明确性脑梗死(OC)组40例,不明病因性脑梗死(UE)组20例,并进行对照分析。结果CE组CRP阳性率最高,CRP水平亦最高,其次为LAA组及OC组,SAO组及UE组最低。以CO中毒为主要危险因素者,其CRP阳性率最高,CRP水平亦为最高,其次为冠心病者。高血压与糖尿病者间比较,无论是从阳性率,还是从CRP水平方面,均无明显差异。结论CRP可能在ACI患者的发生、发展中起一定作用,且其水平随脑梗死类型的不同而变化。

The changes and clinical significance of serum C-reactive protein in patients with different types of acute cerebral infarction

Objectives To investigate the regularity of fluctuation and clinical significance of serum C-reactive protein(CRP) level in patients with acute cerebral infarction(ACI).Methods 166 inpatients(90 males and 76 females) were divided into five groups including 46 cases of large artery atherosclerotic CI(LAA),40 cases of small artery occlusive CI(SAO),20 cases of cardiogenic CI(CE),40 cases of CI with other etiology(OC) and 20 cases of CI with undetermined etiology(UE) according to Trial of ORG 10172 in Acute Stroke Treatment(TOAST).CRP level of 100 inpatients was detected and analysed by enzyme-linked immunoadsorbent assay(ELISA).Results Both level of CRP and positive rate of CRP in CE group were the highest,then were LAA group,OC group,SAO group and UE group.Risk factors of stroke included coronary heart disease,hypertension,diabetes and CO intoxication,etc.Both level of CRP and positive rate of CRP in CO intoxication group were the highest,then was coronary heart disease group.However,there were no notable differences between hypertension and diabetes groups.Conclusions CRP may play a certain role in the occurrence and development of ACI and presents different levels in different types of stroke.