不同亚型脑梗死患者hs-CRP与CD3+/HLA-DR+变化的意义

目的探讨发病不同亚型急性脑梗死（ACl）患者入院后不同时间血清超敏C反应蛋白（hs-CRP）与CD3^＋／HLADR^＋水平动态变化的意义。方法采用酶联免疫吸附法及流式细胞技术观察89例发病24h内的大动脉粥样硬化脑梗死（LAA）、小动脉闭塞性脑梗死（SAO）、心源性栓塞性脑梗死（cE）、其他病因明确性脑梗死（0c）、不明病因性脑梗死（UE）等患者，入院后第1、3、7、14天hs-CRP与CD3^＋／HLA-DR^＋水平及神经缺损程度的变化。结果ACl各亚型组患者在入院后第1、3天的hs-CRP与CD3^＋/HLA-DR^＋水平均高于对照组（P〈0、05），第14天LAA与CE组仍高于对照组（P〈0.05），hs-CRP与CD3^＋／HLA-DR^＋水平呈正相关（r=0．493，P〈001），LAA与CE组神经系统缺损程度明显重于SAO、OC及UE组（P〈0．05），且hs-CRP水平与ACl患者神经缺损程度呈正相关（r=0．475，0、482，P〈0．01）。结论不同亚型的ACl发病过程中存在不同程度的炎症和免疫反应，hs-CRP与CD.^＋／HLA-DR^＋水平与缺血性脑损伤严重程度密切相关。

Clinical study and significance of hs-CRP and CD3 +/HLA-DR in patients with different acute cerebral infarction subtypes

Objective To investigate the dynamic changes of highly sensitive C-reactive protein(hs-CRP) and CD_3~+/HLA-DR~+ in patients with different acute cerebral infarction subtypes at different time points.Method 1-day,3-day,7-day,14-day after admission,the levels of hs-CRP and CD_3~+/HLA-DR~+ in 89 cases with different ACI subtypes including LAA,SAO,CE,OC and UE were detected using ELISA and FCM methods.The degrees of neurological impairment were also evaluated.Result: Contrast to the control group,the levels of hs-CRP and CD_3~+/HLA-DR~+ in different ACI subtype groups were higher 1-day and 3-day after admission(P<0.05).The levels of hs-CRP and CD_3~+/HLA-DR~+ in LAA and CE groups after 14-day were still higher than those in control group(P<0.05).There was a positive correlation between the levels of hs-CRP and CD_3~+/HLA-DR~+(r=0.493,P<0.01).The neurological impairment scores in LAA and CE group were obviously higher than those in SAO,OC,UE groups.The levels of hs-CRP also had a positive correlation with the degrees of neurological impairment(r=0.475,0.482,P<0.01).Conclusion There were inflammation and immunological reactions in the process of different acute cerebral infarction subtypes.The levels of hs-CRP and CD_3~+/HLA-DR~+ were closely related with the degrees of neurological impairment.