摘要
目的观察急性缺血性脑卒中(PIS)患者入院后C反应蛋白(CRP)、同型半胱氨酸(Hcy)、神经元特异性烯醇化酶(NSE)、可溶性细胞间粘附分子1(sICAM-1)水平变化,评估上述指标对进展性缺血性脑卒中的预测价值。方法选取2018年1月~2020年12月保定市第一中心医院神经内科住院的213例急性缺血性脑卒中患者。根据NIHSS评分进展分为PIS组和非PIS组。PIS组根据入院时脑梗死体积分为大、中、小梗死灶组。观察入院后24 h、48 h、72 h、5 d、7 d CRP、sICAM-1、Hcy、NSE变化。结果PIS组各时间点的CRP和sICAM-1水平均高于非PIS组,差异有统计学意义(P<0.05)。非PIS组CRP和sICAM-1呈下降趋势,PIS组CRP和sICAM-1呈升高趋势,CRP在72 h达峰,sICAM-1的中、小梗死灶组在72 h达峰,大梗死灶组在5 d达峰。入院7 d内非PIS组Hcy水平变化不显著,PIS组Hcy呈上升趋势。入院24 h内PIS组中、大梗死灶Hcy水平高于非PIS组,差异有统计学意义(P<0.05),但小梗死灶与非PIS组差异无统计学意义(P>0.05)。同时点PIS组大梗死灶的Hcy水平高于中梗死灶组和小梗死灶组,差异有统计学意义(P<0.05)。PIS组和非PIS组NSE在早期均呈上升趋势,入院24和48 h内大梗死灶组NSE高于中梗死灶组,中梗死灶组NSE高于小梗死灶组,差异均有统计学意义(P<0.05)。结论进展性缺血性脑卒中患者血清CRP、sICAM-1水平明显升高且在发病早期呈动态上升趋势,可作为预测PIS发生的参考指标。Hcy在评估患者发生PIS的风险时,需结合梗死灶面积等因素综合考虑。NSE在预测PIS发生中的价值有限。
Objective To observe the changes of CRP,Hcy,NSE and sICAM-1 in patients with acute ischemic stroke after admission,and to evaluate the predictive value of the above indexes for progressive ischemic stroke.Methods From January 2018 to December 2020,213 patients with acute ischemic stroke in the Department of neurology were selected as the research objects.According to NIHSS score,the patients were divided into PIS group and non PIS group.The PIS group was divided into large,medium and small infarct groups according to the infarct volume at admission.The changes of CRP,sICAM-1,Hcy and NSE were observed 24 h,48 h,72 h,5 day and 7 day after admission.Results The levels of CRP and sICAM-1 in PIS group were significantly higher than those in non PIS group,P<0.05.CRP and sICAM-1 decreased in non PIS group,increased in PIS group,and peaked at 72 h,peaked at 72 h in small and medium infarction group,peaked at 5 day in large infarction group.The Hcy level in non PIS group did not change significantly within 7 days after admission,but increased in PIS group.Within 24 hours after admission,the Hcy levels of middle and large infarcts in PIS group were higher than those in non PIS group(P<0.05),but there was no significant difference between small infarcts and non PIS group(P>0.05).At the same time,the Hcy level of large infarction in PIS group was higher than that of medium infarction group and small infarction group,and the difference was statistically significant(P<0.05).NSE in PIS group and non PIS group showed an upward trend in the early stage.Within 24 hours and 48 hours after admission,NSE in large infarction group was higher than that in medium infarction group,NSE in medium infarction group was higher than that in small infarction group,and the differences were statistically significant(P<0.05).Conclusion The serum levels of CRP and sICAM-1 in patients with progressive ischemic stroke are significantly increased,and they show a dynamic upward trend in the early stage of onset,which can be used as a reference index to
作者
卢军栋
苏鹏
孙静
王康
Lu Jundong;Su Peng;Sun Jing(Department of NeurologyⅡ,Baoding First Central Hospital,Baoding 071000,China)
出处
《中华保健医学杂志》
2021年第6期604-607,共4页
Chinese Journal of Health Care and Medicine
基金
保定市科技计划项目(2041ZF080)。
