Hcy和hs-CRP在急性脑血管疾病中的诊断意义

目的：检测急性脑梗死患者血清同型半胱氨酸（Hcy）和高敏C-反应蛋白（hs-CRP）含量,探讨Hcy和hs-CRP在急性脑缺血和脑梗死中的临床意义和诊断价值。方法：112例（男79,女33）急性脑梗死患者,年龄（62.8±10.5）岁和正常健康人对照组53例（男35,女18）,年龄47岁～76岁,平均（60.7±12.3）岁,放射免疫分析（RIA）测定CRP,时间偏振荧光化学分析测定血清Hcy水平,比较急性脑梗死组患者与正常对照组之间血清含量的差异并和脑梗死患者神经功能缺失程度作相关性分析。结果：轻、中和重度组脑功能损害组与正常对照组之间血清CRP及Hcy水平均有显著性差异（P〈0.01）,脑梗死患者中轻度脑功能障碍组和重度脑功能受损组之间,Hcy水平也有显著性差异（P〈0.05）;脑梗死患者神经功能缺失程度与血清Hcy水平呈显著正相关（r=0.47,P〈0.05）。脑梗死患者与健康对照组之间血清CRP水平有显著性差异（P〈0.001）,脑梗死患者各组之间CRP水平也有显著性差异（P〈0.01）,且血清CRP水平与NIHSS评分有显著相关性（r=0.89,P〈0.01）。结论：脑梗死患者血中Hcy和hs-CRP水平均显著升高,并与脑梗死严重程度密切相关,Hcy和hs-CRP有望成为判断脑梗死病情严重程度和转归的预测因子。

The Diagnostic and Prognostic Significance of Changes of Serum CRP and Hcy Levels in Patients with Acute Cerebral Ischemia and Infarction

Objective To study the changes of serum levels of C reactive protein（CRP） and homocystine in patients with acute cerebral infarction and their correlationship with clinical function impairment（NIHSS）.Methods 112 patients with acute cerebral infarction（79 male and 33 female,age,62.8±10.5 years old） and 53 healthy controls were included in this study.Serum levels of CRP were measured with radioimmunoassay,serum levels of Hcy was analyzed with fluorescence polarization time chemiluminescence analysis.The significance of data and correlationship with NIHSS were stadied with t-test and spearman analysis respectively.Results The serum levels of CRP and Hcy were significantly higher in patients with acute cerebral than those controls（P〈0.01）.Furthermore,the levels of CRP and Hcy were positively correlated with clinical functional disorder score（P〈0.05）.Conclusion CRP and Hcy may play important pathophysiologic roles in acute cerebral ischemia and infarction and it may also be an independent predictor for clinical outcome.