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目的探讨脑梗死急性期高敏感 C 反应蛋白(hs-CRP)对脑梗死远期预后的评估价值。方法选取首次急性脑梗死患者99例,在72 h 内检测血清 hs-CRP,随访1年,将死亡及再发缺血性血管病变记录为终点事件。将所有患者分为 CRP 正常组(hs-CRP≤3 mg/L)和 CRP 增高组(hs-CRP>3 mg/L),分别对两组患者进行生存分析比较。采用多变量 Logistic 回归分析 hs-CRP 增高、高血压、糖尿病、冠心病、高血脂、年龄、吸烟、饮酒等危险因素对终点事件的影响。结果 hs-CRP>3mg/L 的患者较 hs-CRP≤3 mg/L 的患者终点事件发生率显著增加(18.18%,5.45%;P=0.044;生存分析,log-rank 检验)。多变量回归分析显示,hs-CRP 增高(OR 3.609;95% CI 0.869～14.992;P=0.047)和吸烟(OR 4.094;95% CI 1.092～15.340;P=0.037)与终点事件独立相关。结论脑梗死急性期 hs-CRP 增高可能是脑梗死发病1年内死亡和再发缺血性血管病变的独立危险因素。
Objective To evaluate the long-term prognosis of cerebral infarction after high-sensitivity C-reactive protein (hs-CRP) in acute cerebral infarction. Methods Ninety-nine patients with acute cerebral infarction were enrolled in this study. Serum hs-CRP levels were measured within 72 hours and followed up for 1 year. The death and recurrent ischemic vascular lesions were recorded as the end point. All patients were divided into CRP normal group (hs-CRP≤3 mg / L) and CRP increased group (hs-CRP> 3 mg / L). Survival analysis was performed on the two groups. Multivariate Logistic regression analysis of hs-CRP increased, hypertension, diabetes, coronary heart disease, hyperlipidemia, age, smoking, drinking and other risk factors on the end point of the event. Results Patients with hs-CRP> 3 mg / L had significantly higher endpoint events than those with hs-CRP ≤ 3 mg / L (18.18%, 5.45%; P = 0.044; survival analysis, log-rank test). Multivariable regression analysis showed that hs-CRP increased (OR 3.609; 95% CI 0.869-14.992; P = 0.047) and smoking (OR 4.094; 95% CI 1.092-15.340; P = 0.037) independently of endpoint. Conclusion The increase of hs-CRP in the acute stage of cerebral infarction may be an independent risk factor of death and recurrent ischemic vascular disease within 1 year after the onset of cerebral infarction.