(韩艳萍)急性缺血性脑卒中血浆hs-CRPHCY及FIB与残余血流动力学分型的相关性研究.doc

急性缺血性脑卒中血浆hs-CRP、HCY及FIB与残余血流动力学分型的 相关性研究 韩艳萍，包红辉，刘敏科，王琼，杨禄萍 甘肃中医药大学附属医院神经内科， 甘肃 兰州 730020 摘要：目的急性缺血性脑卒中，炎症不仅是脑卒中后所致的结果，而且参与神经组织的损伤，而对非栓塞性脑梗死急性期超敏C反应蛋白、同型半胱氨酸及纤维蛋白原与病灶受累血管血流动力学分型的相关性研究却较少。因此本文将探索上述血浆标志物与残余血流动力学分型的相关性和血流动力学分型对早期神经功能缺损严重性的预测。方法共有96例入组，发病后72小时内采用LX-20全自动生化分析仪，对血浆hs-CRP、HCY进行测定，采用凝固法对FIB进行测定。运用探头频率为2MHz的双通道经颅多普勒仪，住院后24小时内进行TCD检查，依据TIBI（Thrombolysis in Brain Ischemia）标准，将受累血管残余血流分为0～5级，将TIBI 0～1级定义为完全闭塞组，TIBI 2～3级为部分闭塞组及TIBI 4～5级为非闭塞组，卒中的严重性通过美国国立卫生研究所脑卒中评分（The National Institutes of Health Stroke Score, NIHSS）来评估。结果完全闭塞、部分闭塞及非闭塞组间，入院时和发病后第7天NIHSS评分，具有统计学意义（P﹤0.05），其两两比较，完全闭塞组与部分闭塞组和非闭塞组间，有统计学意义（P﹤0.05）。血浆hs-CRP、FIB与残余血流分型，具有显著性相关（r=-0.29，P=0.008；r=-0.31，P=0.004）, 然而HCY无显著性相关（r=-0.17，P=0.07）。三组间hs-CRP和FIB，均具有统计学意义（P﹤0.05），而HCY差异无统计学意义（P0.05）。结论根据残余血流动力学分型，可预测完全闭塞较部分闭塞组及非闭塞组早期神经功能缺损严重。急性期血浆hs-CRP、FIB与残余血流动力学分型具有显著性负相关，即高水平的血浆hs-CRP和FIB，具有较差的残余血流分型。 关键词：急性缺血性脑卒中；超敏C反应蛋白；纤维蛋白原；经颅多普勒；血流动力学 The relationship between plasma hs-CRP，HCY and FIB level of acute ischemic stroke patients with residual hemodynamic types HAN Yanping,BAO Honghui ,et al Affiliated Hospital of Gansu University of Chinese Medicine,Lanzhou 730020 Abstract: Objective: Inflammation is not only a result after stroke ,but also participating in the nervous tissue injury in acute ischemic stroke, there is a lack of correlation study of plasma hs-CRP,HCY and FIB level and residual hemodynamic types for acute non-thrombosis cerebral infarction. So the purpose of this study is to explore the relationship between plasma markers and the residual hemodynamic types,and whether it can early predict the severity of neurological deficit.Methods: We prospectively studied 96 patients with acute ischemic stroke who were admitted within 72 hours after the onset of symptoms.Plasma hs-CRP , HCY measurements were obtained from patients within 72 hours after onset using automatic biochemical analyzer of the LX – 20, FIB is determined using freezing method.Using dual-channel transcranial Doppler with 2 MHZ Probe,