合并大脑中动脉狭窄的急性缺血性卒中患者外周血炎性因子与一年期预后的相关性研究

目的探讨血清同型半胱氨酸(homocysteine,HCY)、超敏C反应蛋白(hypersensitive C-reactive protein, hs-CRP)等炎性因子与合并大脑中动脉(middle cerebral artery,MCA)狭窄的急性缺血性卒中患者预后的相关性。方法本研究纳入合并MCA狭窄的急性非心源性缺血性卒中患者。根据磁共振血管成像(magnetic resonance angiography,MRA),将MCA狭窄分为轻度狭窄组(〈50%),中度狭窄组(50%~69%),重度狭窄组(70%~99%)和闭塞组(100%)。记录受试者外周血中的HCY、hs-CRP水平。1...

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Published in中国卒中杂志 Vol. 11; no. 11; pp. 954 - 959
Main Author 邹昕颖 龚浠平 濮月华 潘岳松 刘丽萍 王伊龙 王拥军
Format Journal Article
LanguageChinese
Published 100050,北京首都医科大学附属北京天坛医院神经病学中心 2016
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ISSN1673-5765
DOI10.3969/j.issn.1673-5765.2016.11.010

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Summary:目的探讨血清同型半胱氨酸(homocysteine,HCY)、超敏C反应蛋白(hypersensitive C-reactive protein, hs-CRP)等炎性因子与合并大脑中动脉(middle cerebral artery,MCA)狭窄的急性缺血性卒中患者预后的相关性。方法本研究纳入合并MCA狭窄的急性非心源性缺血性卒中患者。根据磁共振血管成像(magnetic resonance angiography,MRA),将MCA狭窄分为轻度狭窄组(〈50%),中度狭窄组(50%~69%),重度狭窄组(70%~99%)和闭塞组(100%)。记录受试者外周血中的HCY、hs-CRP水平。1年期预后以改良Rankin量表(modified Rankin Scale,mRS)评分为判断指标。结果共纳入977例符合入组标准的患者,完成1年期随访者952例。HCY、hs-CRP水平在MCA各不同狭窄水平亚组中无显著差异。卒中后1年预后不良的患者(704例)中与预后良好(248例)患者相比,HCY、hs-CRP水平显著增高,但仅hs-CRP是预后不良的独立预测因子[比值比(odds ratio, OR)1.060,95%可信区间(confidence interval,CI)1.027~1.093,P=0.0003]。炎性因子同时升高(hs-CRP〉3 mg/L,HCY〉15μmol/L)预测1年期预后不良的作用高于单个炎性因子(OR 4.487,95%CI 1.994~10.098,P=0.0003)。结论 hs-CRP水平增高是急性缺血性卒中1年期预后不良的独立预测因子。较之单个增高的炎性因子,hs-CRP和HCY同时增高预测卒中预后不良更有价值。
Bibliography:11-5434/R
Ischemic Stroke;Inlfammatory mediator;Prognosis
ZOU Xin-Ying, GONG Xi-Ping, PU Yue-Hua, PAN Yue-Song, LIU Li-Ping, WANG Yi-Long, WANG Yong-Jun(Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China)
Objective To investigate the correlation of inlfammatory mediators, such as homocysteine (HCY) and hypersensitive C-reactive protein (hs-CRP), and the prognosis in acute ischemic stroke with middle cerebral artery stenosis. Methods The patients with acute noncardioembolic ischemic stroke with middle cerebral artery (MCA) stenosis were recruited, analyzed by MRA as none to mild (〈50%), moderate (50%-69%), severe (70%-99%), or occlusive (100%). The peripheral levels of HCY and hs-CRP were recorded. All patients were assessed of 1-year outcome by modiifed Rankin Scale (mRS). Results Totally 977 patients satisfied the inclusion criteria and 952 of those carried out 1-year follow-up. The levels of HCY and hs-CRP had no significant differences in patients with categor
ISSN:1673-5765
DOI:10.3969/j.issn.1673-5765.2016.11.010