血清高敏C反应蛋白对急性脑梗塞风险的临床预测价值

摘要

目的:探讨血清高敏C反应蛋白(hsCRP)对临床急性脑梗塞风险的预测价值.方法: 选择我院诊断为急性脑梗塞的122例患者为脑梗塞组,另选择同期入院健康体检的122例非急性脑梗死患者为非脑梗死组.比较两组颈动脉内-中膜厚度(IMT)、斑块位置及hsCRP水平,并分析不同IMT厚度及斑块类型与hsCRP水平的关系.结果:与非脑梗死组比较,脑梗死组IMT增厚(1.6%比19.7%)、颈动脉粥样硬化斑块(15.6%比69.7%)、不稳定斑块比例(8.2%比60.7%)明显升高(P均=0.001);在脑梗死患者中,与IMT正常患者比较,IMT增厚和IMT斑块形成患者hsCRP水平明显升高[(4.7±1.6)mg/L比(8.5±2.5) mg/L比(12.6±3.9) mg/L],且IMT斑块形成患者hsCRP水平明显高于IMT增厚者(P均=0.001);不稳定斑块患者hsCRP水平明显高于稳定斑块患者[(13.7±2.7) mg/L比(9.1±2.1) mg/L,P=0.001].结论:于脑梗塞组和非脑梗死组,与IMT正常患者比较,IMT增厚和IMT斑块形成患者hsCRP水平明显升高,不稳定斑块患者hsCRP水平又明显高于稳定斑块患者,hsCRP可作为临床颈动脉硬化和急性脑梗塞风险预测指标.%Objective:To explore predictive value of serum high sensitive C reactive protein (hsCRP) for clinical risk of acute cerebral infarction (ACI).Methods: A total of 122 ACI patients diagnosed in our hospital were regarded as cerebral infarction (CI) group, another 122 patients without ACI who received physical examination in our hospital during the same period were selected as non-CI group.Intima-medium thickness (IMT), plaque location and hsCRP level were compared between two groups, and the relationship among different IMT, plaque types and hsCRP level was analyzed.Results: Compared with non-CI group, there were significant rise in percentages of IMT thickening (1.6% vs.19.7%), carotid atherosclerotic plaques (15.6% vs.69.7%) and unstable plaques (8.2% vs.60.7%) in CI group, P=0.001 all;among CI patients, compared with normal IMT patients, there was significant rise in hsCRP level [(4.7±1.6) mg/L vs.(8.5±2.5) mg/L vs.(12.6±3.9) mg/L] in IMT thickening and IMT plaque formation patients, and hsCRP level of plaque formation patients was significantly higher than that of IMT thickening patients, P=0.001 all;hsCRP level of unstable plaque patients was significantly higher than that of stable plaque patients [(13.7±2.7) mg/L vs.(9.1±2.1) mg/L, P=0.001].Conclusion: Compared with normal IMT patients, there was significant rise in hsCRP level in IMT thickening and IMT plaque formation patients, and hsCRP level of unstable plaque patients was significantly higher than that of stable plaque patients in acute cerebral infarction and non-CI patients, so hsCRP can be used as risk predictor for carotid atherosclerosis and acute cerebral infarction