Changes of serum high sensitive C-reactive protein in patients with acute cerebral infarction

摘要

BACKGROUND: Serum high sensitive C-reactive protein (hs-CRP), which regards as a high sensitive mark of systemic inflammatory response syndrome, can provide a lot of valuable information for the treatment and prognosis of cerebrovascular disease.OBJECTIVE: To observe the differences of blood glucose, lipid, homocysteine and previous disease history among patients with acute cerebral infarction at various levels of hs-CRP and compare changes of hs-CRP of patients with various degrees ofneurologic impairment.DESIGN: Contrast observation.SETTING: Department of Neurology, Shenzhou Hospital, Shenyang Medical College.PARTICIPANTS: A total of 102 patients with acute cerebral infarction were selected from Department of Neurology, Shenzhou Hospital of Shenyang Medical College from February 2005 to September 2006,including 55 males and 47 females aged from 55 to 86 years. All accepted patients met the diagnostic criteria of cerebral infarction established by the Fourth National Cerebrovascular Disease Academic Meeting and were diagnosed with CT or MRI examination. All patients provided the confirmed consent. Based on clinical criteria of neurologic impairment established by the Fourth National Cerebrovascular Disease Academic Meeting, patients were randomly divided into mild group (0- 15 points, n =46), moderate group (16- 30points, n =38) and severe group (31 - 45 points, n =18). In addition, based on hs-CRP level within 72 hours,patients were divided into normal group (hs-CRP ≤ 3 mg/L, n =53) and increasing group (hs-CRP ＞ 3 mg/L,n =49).METHODS: ① 2 mL venous blood was selected from hospitalized patients in the next morning to separate serum. Quantitative measurement of hs-CRP was dealt with Latex Enhnced Turbidimetric Immunoassay (LETIA). ② Fasting venous blood was colleted from hospitalized patients in the next morning to measure numeration of white blood cells, fibrinogen, blood glucose, total cholesterol (TC), triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and homocysteine. ③Measurement data were compared with t test or analysis of variance.MAIN OUTCOME MEASURES: ① Comparisons of serum biochemical indexes among patients with various levels of hs-CRP; ② comparisons of risk factors among patients with various levels of hs-CRP; ③comparisons of levels of hs-CRP among patients with various degrees of clinical neurologic impairment.RESULTS: A total of 102 patients were involved in the final analysis. ① Plasma fibrinogen and numeration of leucocytes were more in the increasing group than those in the normal group (t =4.39, 3.54,P ＜ 0.01); while, there were no significant differences of blood glucose, TC, TG, HDL-C, LDL-C and homocysteine between the two groups (P ＞ 0.05). ② Percentage of patients with hypertension and diabetes mellitus (DM) was higher in the increasing group than the normal group ( x2=3.98, 4.23, P ＜ 0.05); while,percentage of patients with smoking in the increasing group was not significantly different from that of patients in the normal group (P ＞ 0.05). ③ Level of hs-CRP of patients with severe neurologic impairment was higher than that of patients with moderate neurologic impairment (t =2.273, P ＜ 0.05); that of patients with moderate neurologic impairment was higher than that of patients with mild neurologic impairment (t =2.586, P ＜ 0.05); that of patients with severe neurologic impairment was obviously higher than that of patients with mild neurologic impairment (t = 4.913, P ＜ 0.01).CONCLUSION: ① With the increase of hs-CRP, plasma fibrinogen and numeration of leucocytes of patients with acute cerebral infarction is increased, especially, they are increased remarkably among patients who have history of diabetes mellitus and hypertension. ② Increase of level of hs-CRP can be regarded as one of marks to evaluate severity of acute stroke.