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目的:分析急性脑卒中患者临床病情严重程度评分与血清炎性因子水平变化的研究。方法:选择诊断急性脑血管病患者120例,依据入院患者格拉斯哥昏迷评分分为轻度(GCS≥12)、中度(GCS,8~11)、重度(GCS,3~7)组,入院24h检测不同程度卒中患者血清降钙素原(PCT,ug/L)、C反应蛋白(CRP,mg/L)、白介素-6(IL-6,U/L)水平变化,分析IL-6、CRP、PCT指标与格拉斯哥昏迷评分(GCS)间相关性,比较3组患者早发卒中相关性肺炎发生率。结果:轻度、中度、重度组患者血清CRP水平3组间比较水平差异有统计学意义(P<0.05)。入院24h血清PCT、CRP、IL-6水平与GCS评分二者间相关性分别为(r=0.309;0.561;0.792,P<0.05)。3组间早发卒中相关性肺炎发生率[(4/40,10%)比(5/40,12.50%)比(16/40,40.00%),χ2=3.005],差异有统计学意义(P<0.05)。结论:急性脑血管病患者病情严重程度评分与机体炎性反应水平关系密切,病情越重,机体炎性反应水平越高,早发卒中相关性肺炎发生率也上升。血清降钙素原水平监测对于早发卒中相关性肺炎诊断价值大。
OBJECTIVE: To analyze the changes of the severity of clinical condition and serum levels of inflammatory cytokines in patients with acute stroke. Methods: One hundred and twenty patients with acute cerebrovascular disease were selected. According to the Glasgow Coma Scale of admission, patients were divided into mild (GCS≥12), moderate (GCS, 8 to 11) and severe (GCS, The levels of serum procalcitonin (PCT, ug / L), C-reactive protein (CRP, mg / L) and interleukin-6 (U / L) were measured in patients with different degrees of stroke. , PCT index and Glasgow coma score (GCS) between the three groups were compared incidence of stroke-associated pneumonia. Results: There was significant difference in serum CRP level between the three groups in mild, moderate and severe group (P <0.05). The correlation between serum PCT, CRP, IL-6 levels and GCS score at admission was (r = 0.309; 0.561; 0.792, P <0.05) at admission. The incidence of stroke-associated pneumonia was higher in the three groups (4/40, 10% vs 5/40, 12.50%, 16/40, 40.00%, χ2 = 3.005) P <0.05). Conclusion: The score of severity of acute cerebrovascular disease is closely related to the level of inflammatory reaction in patients with acute cerebrovascular disease. The more severe the disease, the higher the level of inflammatory reaction and the higher incidence of stroke-associated pneumonia. Serum procalcitonin levels for early diagnosis of stroke-associated pneumonia is of great value.