Clinical significance and changes of serum high-sensitivity Creactive protein and neuron-specific enolase in acute cerebral infarction patients with different risk factors
-
摘要:目的 探讨不同危险因素的急性脑梗死(ACI)患者血清超敏C反应蛋白(hs-CRP)、神经元特异性烯醇化酶(NSE)含量的变化及临床意义。方法 选取20例健康对照者与68例急性脑梗死患者，根据危险因素将脑梗死患者分为单纯脑梗死组、脑梗死合并高血压病组、脑梗死合并糖尿病组。采用酶联免疫吸附实验测定血清中hs-CRP、NSE的浓度，比较不同危险因素脑梗死患者hs-CRP及NSE含量变化。采用美国国立卫生院卒中量表(NIHSS)评估神经缺损程度。结果 ACI患者入院血清hs-CRP、NSE浓度显著高于健康对照组(P < 0.01)。ACI患者中，脑梗死合并高血压组、脑梗死合并糖尿病组患者血清hs-CRP、NSE浓度显著高于单纯脑梗死患者(P < 0.05)。ACI患者血清hs-CRP、NSE浓度与NIHSS评分呈线性正相关。Pearson相关分析显示, ACI患者血清hs-CRP水平与NSE水平呈显著线性正相关(P < 0.05)。结论 急性脑梗死患者合并高血压病、糖尿病会加重血管炎性反应及神经功能损害。
-
关键词:
- 脑梗死 /
- 超敏C反应蛋白 /
- 神经元特异性烯醇化酶 /
- 美国国立卫生院神经功能缺损评分 /
- 高血压 /
- 糖尿病
Abstract:Objective To explore clinical significance and changes of serum high-sensitivity C reactive protein (hs-CRP) and neuron-specific enolase (NSE) in acute cerebral infarction (ACI) patients with different risk factors.Methods Totally 20 healthy people and 68 patients with ACI were selected, and the ACI patients were divided into simple ACI group, ACI plus hypertension group and ACI plus diabetes group according to risk factors. The serum levels of hs-CRP and NSE were measured by ELISA, and the changes of hs-CRP and NSE in cerebral infarction patients with different risk factors were compared. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological deficits.Results The serum hs-CRP and NSE levels in ACI patients were significantly higher than those in control group at adnission (P < 0.01). In ACI patients, the serum hs-CRP and NSE levels in ACI plus hypertension group and ACI plus diabetes group were significantly higher than those in simple ACI group (P < 0.05). Serum hs-CRP and NSE levels in ACI patients were positively correlated with NIHSS scores. Pearson correlation analysis showed that serum hs-CRP level was positively correlated with NSE level in ACI patients (P < 0.05).Conclusion Acute cerebral infarction patients may suffer more serious aggravate vasculitis and neurological impairment when complicated with hypertension and diabetes. -
-
表 1 4组患者一般资料比较(x±s)[n(%)]
一般资料 健康对照组(n=20) 单纯脑梗死组(n=20) 脑梗死合并糖尿病组(n=22) 脑梗死合并高血压病组(n=26) 年龄/岁 62.53±10.14 63.24±12.22 60.56±10.98 62.67±11.67 女 7(35.00) 8(40.00) 7(31.82) 9(34.62) 男 13(65.00) 12(60.00) 15(68.18) 17(65.38) 甘油三酯/(mmol/L) 1.71±1.23 1.56±0.89 1.64±1.05 1.58±1.12 总胆固醇/(mmol/L) 4.31±1.04 4.23±1.17 4.42±1.03 4.55±1.01 高密度脂蛋白胆固醇/(mmol/L) 1.12±0.26 1.17±0.22 1.14±0.23 1.15±0.28 低密度脂蛋白胆固醇/(mmol/L) 2.53±0.88 2.65±0.97 2.71±1.21 2.66±1.07 肌酐/(μmol/L) 76.55±12.50 75.31±11.30 72.86±11.50 74.66±10.90 尿酸/(μmol/L) 301.71±54.67 305.33±59.67 302.43±56.33 303.25±55.89 
下载: 导出CSV
表 2 4组患者血清hs-CRP、NSE浓度比较(x±s)
指标 健康对照组(n=20) 单纯脑梗死组(n=20) 脑梗死合并糖尿病组(n=22) 脑梗死合并高血压病组(n=26) hs-CRP/(mg/L) 0.82±0.68 4.26±1.28** 6.99±1.16**# 7.14±0.88**# NSE/(μg/L) 5.75±1.85 24.77±2.29** 37.48±3.61**# 37.87±4.01**# hs-CRP: 超敏C反应蛋白; NSE: 神经元特异性烯醇化酶。与健康对照组比较, **P < 0.01; 与单纯脑梗死组比较, #P < 0.05。
下载: 导出CSV
表 3 血清hs-CRP、NSE浓度与NIHSS评分的相关性(x±s)
指标 轻度组(n=25) 中度组(n=28) 重度组(n=15) hs-CRP/(mg/L) 5.63±1.62 6.20±1.43* 7.45±0.74*# NSE/(μg/L) 29.75±5.51 32.82±5.46* 41.88±4.55*# hs-CRP: 超敏C反应蛋白; NSE: 神经元特异性烯醇化酶。与轻度组比较, *P < 0.05; 与中度组比较, #P < 0.05。
下载: 导出CSV
-
[1] Chang L T, Yuen C M, Liou C W, et al. Link between interleukin-10 level and outcome after ischemic stroke[J]. Neuroimmunomodulation, 2010, 17: 223-228. doi: 10.1159/000290038
[2] Basic Kes V, Simundic A M, Nikolac N, et al. Pro-inflammatory and anti-inflammatory cytokines in acute ischemic stroke and their relation to early neurological deficit and stroke outcome[J]. Clin Biochem, 2008, 41: 1330-1334. doi: 10.1016/j.clinbiochem.2008.08.080
[3] Tuttolomondo A, Di Raimondo D, Pecoraro R, et al. Immune-inflammatory markers and arterial stiffness indexes in subjects with acute ischemic stroke[J]. Atherosclerosis, 2010, 213: 311-318. doi: 10.1016/j.atherosclerosis.2010.08.065
[4] Song I U, Kim J S, Kim Y I, et al. Relationship between high-sensitivity C-reactive protein and clinical functional outcome after acute ischemic stroke in a Korean population[J]. Cerebrocasc Dis, 2009, 28: 545-550. doi: 10.1159/000247597
[5] FAN Y Q. The clinical significance of detection of 6-keto-PGF1α and NSE in new born with hypoxia ischemic enpholopathy [J]. Appl J Gener Pract, 2011, 9(12): 1952-1953.
[6] 中华神经外科学会. 各类脑血管疾病诊断要点[J]. 中华神经科杂志, 1996, 29: 379-380. doi: 10.3760/j.issn:1006-7876.1996.06.006 [7] O′Donnell M J, Xavier D, Liu L, et al. Risk factors for ischemic and intracerebral hemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study[J]. Lancet, 2010, 376(9735): 112-123. doi: 10.1016/S0140-6736(10)60834-3
[8] 白书玲, 李建军. C-反应蛋白与动脉粥样硬化[J]. 中华心血管杂志, 2004, 32(8): 765-768. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHXX200408035.htm [9] Pearson T A, Mensah G A, Alexander R W, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association[J]. Circulation, 2003, 107(3): 499-511. doi: 10.1161/01.CIR.0000052939.59093.45
[10] Torzewski M, Rist C, Mortensen R F, et al. C-reactive protein in the arterial intima: role of C-reactive protein receptor-dependent monocyte recruitment in atherogenesis[J]. Arterioscler Thromb Vasc Biol, 2000, 20(9): 2094-2099. doi: 10.1161/01.ATV.20.9.2094
[11] Purroy F, Montaner J, Molina C A, et al. C-reactive protein predicts further ischemic events in transient ischemic attack patients[J]. Acta Neurol Scand, 2007, 115(1): 60-66. doi: 10.1111/j.1600-0404.2006.00715.x
[12] Azarpazhooh M R, Mobarra N, Parizadeh S M, et al. Serum high-sensitivity C-reactive protein and heat shock protein 27 antibody titers in patients with stroke and 6-month prognosis[J]. Angiology, 2010, 61(6): 607-612. doi: 10.1177/0003319709360524
[13] Rajeshwar K, Kaul S, Al-Hazzani A, et al. C-reactive protein and nitric oxide levels in ischemic stroke and its subtypes: correlation with clinical outcome[J]. Inflammation, 2012, 35(3): 978-984. doi: 10.1007/s10753-011-9401-x
[14] Pandey A, Saxena K, Verma M, et al. Correlative study between neuron-specific enolase and blood sugar level in ischemic stroke patients[J]. J Neurosci Rural Pract, 2011, 2(1): 50-54. doi: 10.4103/0976-3147.80099
[15] Rizvi I, Islam N, Ullah E, et al. Correlation between serum neuron specific enolase and functional neurological outcome in patients of acute ischemic stroke[J]. Ann Indian Acad Neurol, 2013, 16(4): 504-504. doi: 10.4103/0972-2327.120442
[16] 周永勤, 黄友敏, 张国庆, 等. 脑梗死及多梗死性痴呆患者血清抵抗素和神经元特异性烯醇化酶的测定[J]. 中华全科医师杂志, 2008, 7(12): 849-850. doi: 10.3760/cma.j.issn.1671-7368.2008.12.021 [17] Herrmann M, Curio N, Jost S, et al. Release of biochemical markers of damage to neuronal and glial brain tissue is associated with short and long term neuropsychological outcome after traumatic brain injury[J]. J Neurol Neurosurg Psychiatry, 2001, 70(1): 95-100. doi: 10.1136/jnnp.70.1.95
[18] 王娉娉. 急性心肌梗死并发急性脑梗死的危险因素及临床特征分析[J]. 当代医学, 2019, 25(8): 31-34. doi: 10.3969/j.issn.1009-4393.2019.08.015 [19] 朱慧颖, 余萍, 梅俊华, 等. 急性脑梗死患者脑微出血的危险因素及其对心脑血管事件发生率影响的研究[J]. 中国现代医学杂志, 2019, 29(3): 88-92. doi: 10.3969/j.issn.1005-8982.2019.03.017 [20] 肖伟, 罗艺, 陈薇, 等. 急性脑梗死合并早期肾损伤患者血清同型半胱氨酸和超敏C反应蛋白联合检测的临床价值[J]. 海南医学, 2018, 29(1): 68-70. doi: 10.3969/j.issn.1003-6350.2018.01.021 [21] 刘振华. 急性脑梗死患者血清超敏C反应蛋白水平与病情发展及演变的关系研究[J]. 中外医疗, 2018, 37(19): 53-55. https://www.cnki.com.cn/Article/CJFDTOTAL-HZZZ201819019.htm
计量
- 文章访问数: 271
- HTML全文浏览量: 161
- PDF下载量: 4
苏公网安备 32100302010246号
