Monitoring the changes in plasm C-reactive protein,fibrinogen and blood white cell in patients with primary hypertension combined with acute cerebral infarction

摘要

BACKGROUND: Inflammatory reaction and the increased level of its accompanying active protein play an important role in the occurrence and development of cerebral infarction. C-reactive protein, fibrinogen and white blood cell, as the monitoring index of inflammatory reaction, are very important in the occurrence and development of acute cerebral infarction. OBJECTIVE: To make a comparison between patients with primary hypertension accompanied with acute cerebral infarction and with simple primary hypertension by observing the changes in plasma C-reactive protein and fibrinogen levels as well as white blood cell and differential counts and analyzing their significances.DESIGN: Controlled observation.SETTING: Ward Building for VIP, Shenzhen Hospital, Peking University.PARTICIPANTS: Totally 133 patients with primary hypertension were selected from Ward Building for VIP, Shenzhen Hospital, Peking University during September 2003 to September 2005. The diagnostic criteria were based on the hypertension diagnosis criteria formulated by the 7th World Health Organization-International Society of Hypertension Guidelines (WHO-ISH) in 1998. The informed consents were obtained from all the participants. The involved patients were assigned into two groups: primary hypertension group, in which, there were 65 patients with primary hypertension ( degree 2), including 42 males and 23 females, with mean age of (61±14)years and mean blood pressure of (162.7±6.8)/(94.2±8.4) mm Hg(1 mm Hg =0.133 kPa), and primary hypertension combined with cerebral infarction group, in which, there were 68 patients with primary hypertension combined with cerebral infarction ( meeting the diagnostic criteria formulated in the 4th National Cerebrovascular Diseases Meeting in 1995 and diagnosed by skull CT or MRI to exclude the patients with lacunar infarction), including 42 males and 26 females, with mean age of (56±15)years and mean blood pressure of (176.4±9.2)/(96.3±9.7) mm Hg.METHODS: Plasm C-reactive protein and fibrinogen levels, and white blood cell and differential counts of patients in the two groups were examined 24 hours after stroke. The above indexes were re-examined in the primary hypertension combined with cerebral infarction group 72 hours after stroke. White blood cell and differential counts were performed with laser method (East Asia FE-9500I RAM-1, Japan). The level of C-reactive protein was measured with turbidimetry (BNII Automatic Systems For Analysis, USA). The level of fibrinogen was measured with algorithm method when prothrombin time was normal and with Clauss method when prothrombin time was abnormal (ACL Automatic Coagulation Analyzer, USA). MAIN OUTCOME MEASURES: The plasm C-reactive protein and fibrinogen levels, and white blood cell and differential counts 24 hours after stroke in two groups and 72 hours after stroke in primary hypertension combined with cerebral infarction group. RESULTS: All the 133 involved patients participated in the result analysis. The plasm C-reactive protein and fibrinogen levels, and white blood cell and neutrophil counts in patients with primary hypertension were all within the normal range. The plasm C-reactive protein and fibrinogen levels, and white blood cell and neutrophil counts in patients with primary hypertension combined with cerebral infarction were significantly higher than those in patients with primary hypertension 24 hours after stroke and 72 hours after stroke respectively[24 hours after stroke:(32.12±11.76) mg/L vs. (5.02±3.21) mg/L;(4.64±0.75) g/L vs. (3.12±0.49) g/L;(9.32±2.81)×109 L-1 vs.(5.78±1.32)×109 L-1;(7.85±2.38)×109 L-1 vs.(3.49±1.28)×109 L-1,t =7.094,5.759,4.106,5.491, respectively,all P < 0.01; 72 hours after stroke: (47.62±18.43) mg/L vs. (32.12±11.76) mg/L;(5.08±0.82) g/L vs.(4.64±0.75) g/L,t =2.864,2.220 , respectively,both P < 0.05]. CONCLUSION: The increase in fibrinogen level and white blood cell count are the important index in monitoring primary hypertension combined with acute cerebral infarction. The increase in plasm C-reactive protein and fibrinogen levels 72 hours after stroke indicates that plasma C-reactive protein and fibrinogen are very important in the development of disease.