CAJ | 학술논문

目的：探讨急性脑梗死患者血清胱抑素C（cystatin C，Cys-C）和C反应蛋白（CRP）水平对病情变化及预后判断的意义。方法选择颈动脉系统进展性脑梗死70例为进展组，非进展性脑梗死168例为非进展组，分别于入院次日（第1天）、第3、7和14天检测血清Cys-C和CRP浓度，行颈部血管超声和经颅多普勒超声（ transcranial Doppler sonography ，TCD）检查，以及卒中量表（ National Institutes of Health Stroke Scale ，NIHSS）和Barthel 指数（ Barthel index ，BI）评分。结果进展组患者入院时颅／颈动脉狭窄率高于非进展组（44．3％ vs 29．8％，P＜0．05），非进展组患者血清Cys-C浓度在第7、14天下降，血清CRP浓度在第3、7、14天下降，进展组患者Cys-C和CRP浓度在第3天明显增加，Cys-C浓度在第14天下降，CRP浓度在第7、14天下降，明显高于非进展组（P＜0．01）。进展组NIHSS和BI评分在入院后进行性增高，非进展组NIHSS和BI评分呈下降趋势（ P＜0．01）。结论观察血清Cys-C及CRP浓度的变化有助于早期发现和及时处理进展性脑梗死。
목적：탐토급성뇌경사환자혈청광억소C（cystatin C，Cys-C）화C반응단백（CRP）수평대병정변화급예후판단적의의。방법선택경동맥계통진전성뇌경사70례위진전조，비진전성뇌경사168례위비진전조，분별우입원차일（제1천）、제3、7화14천검측혈청Cys-C화CRP농도，행경부혈관초성화경로다보륵초성（ transcranial Doppler sonography ，TCD）검사，이급졸중량표（ National Institutes of Health Stroke Scale ，NIHSS）화Barthel 지수（ Barthel index ，BI）평분。결과진전조환자입원시로／경동맥협착솔고우비진전조（44．3％ vs 29．8％，P＜0．05），비진전조환자혈청Cys-C농도재제7、14천하강，혈청CRP농도재제3、7、14천하강，진전조환자Cys-C화CRP농도재제3천명현증가，Cys-C농도재제14천하강，CRP농도재제7、14천하강，명현고우비진전조（P＜0．01）。진전조NIHSS화BI평분재입원후진행성증고，비진전조NIHSS화BI평분정하강추세（ P＜0．01）。결론관찰혈청Cys-C급CRP농도적변화유조우조기발현화급시처리진전성뇌경사。
Objective To explore the signification of variation of serum Cys-C and CRP in patients with acute cerebral infarc-tion in the evolution of illness and the prognosis .Methods 70 patients with progressive crotid system cerebral infarction were selected as progressive group ,and 168 patients with non-progressive crotid system cerebral infarction were selected as non-progressive group .We respectively tested the content of serum Cys-C and serum CRP,used the carotid ultrasonography and TCD to do the examination and to evaluate the level of NIHSS and BI on the 2nd day of admission (1st day),the 3rd day,the 7th day,and the 14th day.Results The vascular stenosis rate in the progressive group was higher than that in the non-progressive group (44.3%vs 29.8%,P<0.05).In the non-progressive group,the content of serum Cys-C descended on the 7th day and the 14th day,and the content of serum CRP descended on the 3rd day,the 7th day and the 14th day.In the progressive group ,the content of serum Cys-C and serum CRP increased prominant-ly on the 3rd day,the content of serum Cys-C decreased on the 14th day and serum CRP on the 7th day and the 14th day,which was much higher than that in non-progerssive group (P<0.01).The scores of NIHSS and BI were increased gradually in progressive group , while it showed a down trend in non-progressive group (P<0.01).Conclusion It is conductive to early detect and immediate treat-ment to the progressive cerebral infarction with the observation of the change of serum Cys -C and serum CRP .