CAJ | 학술논문

目的探讨炎性标记物对急性脑梗死患者早期预后的影响. 方法连续收集急性脑梗死患者272例,将脑梗死患者按超敏C反应蛋白(hs-CRP)水平分为低hs-CRP组(hs-CRP≤3 mg/L)及高hs-CRP组(hs-CRP＞3 mg/L),采集研究对象的基本信息和疾病史,同时进行入院后的TOAST卒中分型,美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)和改良的Rankin量表(mRS)评分收集,检测入院后24 h内血白细胞计数、血糖、血同型半胱酸及hs-CRP值.并采用多因素Logistic回归分析进行急性脑梗死早期预后不良的独立危险因素探讨. 结果高hs-CRP水平组较低hs-CRP水平组的患者心房颤动病史、心源性脑栓塞、血同型半胱氨酸、血糖、白细胞计数,入院后(1d、7d、14 d)NIHSS评分、BI评分和mRS评分差异均有统计学意义(P＜0.05).hs-CRP(OR=0.876,95％CI:0.817～0.917,P＜0.001)、白细胞计数(OR=1.137,95％ CI:1.013～1.275,P=0.029)、脂代谢紊乱(OR=2.863,95％CI:1.561～5.250,P＜0.001)及卒中后第1天BI评分(OR=1.038,95％ CI:1.001～1.077,P=0.047)是急性脑梗死患者早期预后不良的独立危险因素.结论炎性标记物hs-CRP及白细胞数增高可能是急性脑梗死患者早期预后不良的独立危险因素.
목적 탐토염성표기물대급성뇌경사환자조기예후적영향. 방법 련속수집급성뇌경사환자272례,장뇌경사환자안초민C반응단백(hs-CRP)수평분위저hs-CRP조(hs-CRP≤3 mg/L)급고hs-CRP조(hs-CRP＞3 mg/L),채집연구대상적기본신식화질병사,동시진행입원후적TOAST졸중분형,미국국립위생연구원졸중량표(NIHSS)、Barthel지수(BI)화개량적Rankin량표(mRS)평분수집,검측입원후24 h내혈백세포계수、혈당、혈동형반광산급hs-CRP치.병채용다인소Logistic회귀분석진행급성뇌경사조기예후불량적독립위험인소탐토. 결과 고hs-CRP수평조교저hs-CRP수평조적환자심방전동병사、심원성뇌전새、혈동형반광안산、혈당、백세포계수,입원후(1d、7d、14 d)NIHSS평분、BI평분화mRS평분차이균유통계학의의(P＜0.05).hs-CRP(OR=0.876,95％CI:0.817～0.917,P＜0.001)、백세포계수(OR=1.137,95％ CI:1.013～1.275,P=0.029)、지대사문란(OR=2.863,95％CI:1.561～5.250,P＜0.001)급졸중후제1천BI평분(OR=1.038,95％ CI:1.001～1.077,P=0.047)시급성뇌경사환자조기예후불량적독립위험인소.결론 염성표기물hs-CRP급백세포수증고가능시급성뇌경사환자조기예후불량적독립위험인소.
Objective To investigate the potential of inflammatory markers for short-term prognosis of acute cerebral infarction.Methods A total of 272 consecutive patients with acute cerebral infarction were divided into a high hs-CRP group (hs-CRP level ＞3 mg/L) and a low hs-CRP group (hs-CRP level ≤3 mg/L),and their general information and medical history were collected.The Trial of Org 10172 in Acute Stroke Treatment (TOAST) stroke subtype classification was conducted and scores of the National Institutes of Health Stroke Scale (NIHSS),the Barthel index (BI) and the modified Rankin scale (mRS) were collected after admission.White blood cell count,blood glucose,blood homocysteine (Hcy) and C-reactive protein were measured within 24 hours following admission.Multivariate Logistic regression analysis was performed to identify independent risk factors for short-term prognosis of acute cerebral infarction.Results Between the high hs-CRP group and the low hs-CRP group,there were significant differences in the incidences of atrial fibrillation history,cardiogenic embolism of TOAST,blood homocysteine,blood glucose,white blood cell count,NIHSS,BI and mRS score 1,7,14 days after admission (P＜0.05 for all).The hs-CRP level (OR=0.876,P＜0.001,95％ CI:0.817-0.917),white blood cell count (OR=1.137,P=0.029,95％ CI:1.013-1.275),lipid metabolism disorders (OR=2.863,P＜0.001,95％ CI:1.561-5.250),and BI score (OR=1.038,P=0.047,95％ CI:1.001-1.077) 1 day after stroke were independent risk factors for short-term prognosis of acute cerebral infarction.Conclusions Increased levels of the inflammatory marker hs-CRP and elevated white blood cell count may be independent risk factors for short-term prognosis of acute cerebral infarction.