Objective To analyze the values of monitoring the changes of serum hepcidin 25 (Hepc25), plasma fer-ritin ( PF) and transferrin ( TRF) in assessment of the early conditions and prognosis of elderly patients with acute cerebral infarction ( ACI) .Methods Totally 227 cases of elderly patients with ACI ( observation group) and 80 healthy subjects as the control group were selected.According to the NIHSS scores after ACI within 24 h, 227 cases were divided into the mild group (n=73), medium group (n=79) and severe group (n=75).The levels of Hepc25, PF and TRF were detected at 24 h, 48 h, 72 h, 7 d, 14 d and 28 d after ACI.The venous blood was extracted to detect the serum Hepc25, PF and TRF in the control group.The levels of Hepc25, PF and TRF were compared at 24 h, 48 h, 72 h, 7 d, 14 d and 28 d after ACI between the observation group and the control group.We determined the prognosis of patients with ACI after the onset of 28 d.The relationships of serum Hepc25, PF and TRF with the neurologic impairment degree and the prognosis were ana-lyzed.Results The levels of Hepc25 and PF at 24 h, 48 h, 72 h, 7 d, 14 d and 28 d after ACI in the observation group were higher than those of the control group, while the level of TRF was lower than that of the control group, the differences were statistically significant (all P<0.05).The levels of Hepc25 and PF in the observation group at 24 h, 48 h, 72 h, 7 d, 14 d and 28 d after ACI increased but the TRF level decreased with the increasing NIHSS scores, the differences were statistically significant (all P<0.05).After the incidence of acute cerebral infarction 28 d, basic recovery was found in 42 cases, significant progress was found in 84 cases, progress was found in 67 cases, and 34 cases had no change, respective-ly in the observation group.The levels of Hepc25 and PF in basic recovery, significant progress and progress at 24 h, 48 h, 72 h, 7 d, 14 d and 28 d after ACI were lower, while the levels of TRF were higher than those in the patients with no change, and the differences were statistically significant ( all P<0.05) .Spearman correlation analysis showed that, at 24 h after ACI, the levels of Hepc25 and PF were positively correlated with NIHSS (r=0.704 and 0.653, all P<0.05), while the level of TRF was negatively correlated with NIHSS ( r=-0.614, P<0.05); at 28 d after ACI, the levels of Hepc25 and PF were negatively correlated with the prognosis of patients ( r=-0.692 and -0.517, all P<0.05) , while the TRF level was positively correlated with the prognosis of patients (r=0.635, P<0.05).Conclusion The levels of Hepc25, PF and TRF in elderly patients with ACI showed dynamic changes in the early stage, and they were related with the severity of the patients'condition and prognosis.%目的：分析血清铁调素25（Hepc25）、铁蛋白（PF）和转铁蛋白（TRF）对老年急性脑梗死患者早期病情及其预后的评估价值。方法227例老年急性脑梗死患者（观察组，其中轻型73例、中型79例和重型75例）分别于发病24、48、72 h 及7、14、28 d 时检测血清 Hepc25、PF 和TRF。80例老年健康体检者（对照组）检测血清Hepc25、PF和TRF。比较发病24、48、72 h及7、14、28 d时观察组和对照组血清Hepc25、PF和TRF。发病28 d时判定观察组预后。分析老年急性脑梗死患者血清Hepc25、PF、TRF与神经功能缺损程度及预后的关系。结果发病24、48、72 h及7、14、28 d时观察组血清Hec25和PF水平均高于对照组，TRF水平均低于对照组（P均＜0．05）；发病24、48、72 h及7、14、28 d时，随NIHSS评分升高，观察组血清Hepc25、PF升高，TRF水平降低（P均＜0．05）。观察组分为基本痊愈42例、显著进步84例、进步67例和无变化34例。发病24、48、72 h及7、14、28 d时，观察组基本痊愈、显著进步和进步者血清Hepc25、PF 均低于， TRF 水平高于无变化者（ P均＜0．05）；发病24 h时血清Hepc25、PF均与NIHSS呈正相关（r＝0．704和0．653，P均＜0．05），TRF与NIHSS呈负相关（r＝－0．614，P＜0．05）；发病28 d时血清Hepc25、PF均与患者预后呈负相关（r＝－0．692和－0．517，P均＜0．05），TRF与患者预后呈正相关（r＝0．635，P＜0．05）。结论老年急性脑梗死患者存在血清Hepc25、PF、TRF动态变化。血清Hepc25、PF、TRF动态变化可用于老年急性脑梗死患者早期病情预后评估。
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