C-反应蛋白与脑梗死相关性研究

目的:探讨脑梗死患者血清C-反应蛋白(CRP)水平的变化与病情严重程度和预后的关系。方法:用免疫比浊法监测108例脑梗死患者血清CRP浓度的动态变化,并与50例脑供血不足患者进行比较。同时比较不同梗死面积组、不同病情严重程度组的CRP水平,并对CRP水平与神经功能缺损程度评分(NDS)的相关性进行评价。结果:1血清CRP浓度:大、小梗死灶组显著高于腔隙性梗死组(P<0.01),大梗死灶组显著高于小梗死灶组(P<0.05)。2脑梗死患者依病情轻、中、重程度不同,血清CRP水平依次增高(P<0.01)。3脑梗死组血清CRP水平在发病后24h至14d明显升高,显著高于对照组(P<0.01);脑梗死组血清CRP水平在发病后5d达峰,发病第28d仍维持较高水平,显著高于对照组(P<0.05)。4发病后24h至28d脑梗死患者血清CRP浓度与NDS评分呈正相关;24～48h相关性显著(P<0.01),随病程延长相关性逐渐减弱(P<0.05)。结论:脑梗死与CRP水平密切相关,血清CRP水平越高,病情越重,预后越差。血清CRP水平可作为脑梗患者的危险预测因子,是判断病情严重程度和预后的一个客观指标。

The relationship between serum C-reactive protein (CRP) level and the severity and prognosis in the patients cerebral ifarction

Objective ：To investigate the relationship between serum C-reactive protein （CRP） level and the severity and prognosis in the patients with cerebral ifarction. Methods：We used immunoturbidimetric assay to monitor the dynamic change of serum CRP concentration of 108 patients with cerebral infarction, compared with 50 cases of cerebral circulation insufficiency patients. Meanwhile we compared the serum CRP concentration among different groups of different infarct size and different severity of disease ,made a evaluation of the correlation between serum CRP concentration and the neural function deficient scale （NDS）. Results：① Serum CRP concentration： large and small infarct group was significantly higher than that in the lacunar infarction group （P〈0. 01）, large infarct group was significantly higher than that in the small infarct group （P 〈0. 05）. ②Along with the exacerbation of the disease , the serum CRP level was increased （P〈0.01）. ③The level of serum CRP of cerebral infarction patients was significantly increased from 24 hours to 14 days after onset （P〈0. 01）; the serum CRP level was highest on the fifth day after onset, and still significantly higher than the control group on the 28 days later （P〈0.05）. ④The serum CRP level and NDS score were positively correlated in 24h-28d later; the dependablity was significant in 24- 48h later （P〈0. 01）, the relevance was gradually weakened with the extension of the course （P〈0. 05）. Conclusion：Cerebral infarction is closely related to the serum CRP level, higher the serum CRP level is ,the illness is more severe, and the prognosis is worse. Serum CRP levels can be used as the predictor of risk for patients with cerebral infarction,it is an objective indicator to estimate the severity and the prognosis.