郭贤莎 胡友明 张新卫 陈汉东

DOI：10.16662/j.cnki.1674-0742.2018.07.179

[摘要] 目的 探討C反应蛋白（C-reactive protein ，CRP）在老年脑梗死检测中的应用价值。方法 回顾性分析该院2014年8月—2017年9月收治的脑梗死老年患者78例，设为鉴别组，另选择同期来院体检的健康人78名，设为参照组；并根据NIHSS评分将脑梗死患者分为轻度、中度、重度3个亚组，根据梗死体积将脑梗死患者分为小梗死病灶、中梗死病灶、大梗死病灶3个亚组，观察对比各组患者CRP水平。结果 鉴别组CRP水平（16.75±2.25）mg/L高于参照组（2.30±0.70）mg/L（t=54.159，P<0.05）。重型组CRP水平（17.03±1.97）mg/L高于轻型组（11.54±1.46）mg/L和中型组（14.75±1.25）mg/L（t=4.430，10.976，P<0.05），且中型组CRP水平（14.75±1.25）mg/L高于轻型组（11.54±1.46）mg/L，（t=9.063，P<0.05）。大梗死病灶患者CRP水平（15.98±2.02）mg/L高于中梗死病灶（9.50±2.35）mg/L和小梗死病灶（9.13±2.07）mg/L（t=8.005，9.768，P<0.05）；中梗死病灶CRP水平（9.50±2.35）mg/L与小梗死病灶（9.13±2.07）mg/L相比差异无统计学意义（t=0.679，P>0.05）。结论 血清CRP水平与脑梗死存在明显关联，CRP水平升高可作为判断脑梗死病情严重程度的独立危险因子，对老年脑梗死患者早期诊断、病情程度和预后判定有重要的参考价值。

[关键词] C反应蛋白；老年脑梗死；诊断价值

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2018）03（a）-0179-03

Clinical Value of C-reactive Protein in Elderly Patients with Cerebral Infarction

GUO Xian-sha， HU You-ming， ZHANG Xin-wei， CHEN Han-dong

Department of Laboratory， Shashi Peoples Hospital， Jingzhou， Hubei Province， 434000 China

[Abstract] Objective This paper tries to investigate the value of C-reactive protein （CRP） in the detection of senile cerebral infarction. Methods A retrospective analysis of 78 elderly patients with cerebral infarction admitted from August 2014 to September 2017 in this hospital was performed as the identification group. Another 78 healthy subjects who were hospitalized during the same period were selected as the reference group. According to the NIHSS score， the patients with cerebral infarction were divided into mild， moderate and severe subgroups. According to infarct volume， the patients with cerebral infarction were divided into three subgroups： small infarction lesion， middle infarct lesion and large infarct lesion. The levels of CRP in each group were compared. Results The CRP level of the discriminant group （16.75 ± 2.25） mg/L was higher than that of the reference group （2.30 ± 0.70） mg/L，（t=54.159， P<0.05）. The level of CRP in severe group （17.03± 1.97） mg/L was significantly higher than that in mild group （11.54±1.46） mg/L and middle group （14.75 ± 1.25） mg/L， （t=4.430， 10.976）， and that in the middle group was（14.75±1.25） mg/L higher than the light group（11.54±1.46） mg/L，（t=9.063， P<0.05）. The CRP level of patients with large infarction（15.98±2.02）mg/L was higher than that of middle infarction （9.50±2.35） mg/L and small infarction（9.13±2.07） mg/L，（t= 8.005， 9.768，P<0.05）； There was no significant difference in CRP level between infarcted lesions （9.50±2.35） mg/L and small infarct size （9.13 ± 2.07） mg/L（t= 0.679， P>0.05）. Conclusion There is a significant correlation between serum CRP level and cerebral infarction. CRP level may be used as an independent risk factor for judging the severity of cerebral infarction. It has important reference value for the early diagnosis， severity and prognosis of elderly patients with cerebral infarction.

[Key words] C-reactive protein； Cerebral infarction； Diagnostic value

脑梗死即缺血性脑卒中，是以神经功能缺失为临床表现的病症，病发原因为局部脑组织血供障碍，且脑组织发生缺血缺氧性病变坏死。根据病发机制，脑梗死又分為脑血栓、脑栓塞、腔隙性脑梗死等亚型。由于老年人身体机能退化严重，且多存在心脑血管慢性合并症，因此发生脑梗死的风险较大。临床病理学研究认为[1]，动脉粥样硬化性血栓性脑梗死是最为常见的脑梗死类型，而因动脉粥样硬化导致的血栓形成过程属于慢性非特异性炎症反应过程，CRP则是反映动脉粥样硬化的高敏标志物，在脑梗死患者的诊断中可用于病情严重程度和预后判定。……