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目的动态观察脑梗死患者发病后1月内补体C3和超敏C-反应蛋白(Hs-CRP)含量的变化趋势及其与梗死灶体积、神经功能缺损程度的相关性。方法分别在发病后12、24、48、72h、7、14d和1月,采用免疫散射比浊法测定56例脑梗死患者补体C3和Hs-CRP含量,观察并记录所有病例的病灶体积、神经功能缺损评分。同时选取46例健康受试者作为对照组。结果(1)病例组补体C3和Hs-CRP在不同测定时点浓度不同(F=163.456和97.622,P<0.001),表现为发病12h时补体C3和Hs-CRP浓度即有所增加,此后随着发病时间的增加浓度呈上升趋势,至发病7d达峰值,随后逐渐下降,至1月时趋于正常。(2)病例组血清C3、Hs-CRP的浓度于发病后12、24、48、72h、7、14d均高于对照组(P<0.05),1月时2组比较无明显差异(P>0.05);(3)病例组血清补体C3、Hs-CRP水平与梗死灶体积有关系,体积越大,血清补体C3、Hs-CRP水平越高。大、中病灶组血清补体C3、Hs-CRP浓度明显高于小病灶组(P<0.05);(4)病例组血清补体C3、Hs-CRP水平与神经功能缺损程度有关系,神经功能缺损越重,血清补体C3、Hs-CRP水平越高。重、中度神经功能缺损组血清补体C3、Hs-CRP浓度明显高于轻度缺损组(P<0.05)。结论(1)急性缺血性脑卒中患者在急性期C3、Hs-CRP含量增高,存在补体系统激活。补体激活可能参与了急性缺血性脑卒中后脑组织的炎症过程;(2)急性缺血性脑卒中患者C3、Hs-CRP与脑梗死体积、神经功能缺损程度之间有密切关系,反映卒中时脑组织的损害程度。
Objective To dynamically observe the changes of complement C3 and high-sensitivity C-reactive protein (Hs-CRP) in patients with cerebral infarction within 1 month after onset and their relationship with infarct volume and the degree of neurological deficits. Methods The levels of complement C3 and Hs-CRP in 56 patients with cerebral infarction were measured by immune nephelometry at 12, 24, 48, 72h, 7, 14d and 1 month after onset. The volume of lesions, nerves Functional impairment score. At the same time, 46 healthy subjects were selected as the control group. Results (1) The concentration of complement C3 and Hs-CRP were different at different time points (F = 163.456 and 97.622, P <0.001), which showed that the concentrations of complement C3 and Hs-CRP increased after 12 hours of onset The onset time of the increase in concentration showed an upward trend to the peak of the incidence of 7d, and then gradually decreased to January tends to be normal. (2) Serum concentrations of C3 and Hs-CRP in case group were significantly higher than those in control group at 12,24,48,72 and 7,14 d after onset (P <0.05), and there was no significant difference between January and 2 (P> 0.05). (3) Serum complement C3 and Hs-CRP levels were correlated with infarct volume in the case group. The larger the volume, the higher the serum complement C3 and Hs-CRP levels. The levels of serum C3 and Hs-CRP in the large and medium lesions were significantly higher than those in the small lesions (P <0.05). (4) Serum levels of complement C3 and Hs-CRP were related to the degree of neurological deficits. Heavy, serum complement C3, Hs-CRP levels higher. Serum levels of complement C3 and Hs-CRP in severe and moderate neurological deficit group were significantly higher than those in mild deficient group (P <0.05). Conclusions (1) Patients with acute ischemic stroke in the acute phase of C3, Hs-CRP levels increased, the presence of complement system activation. Complement activation may be involved in the inflammatory process of brain tissue after acute ischemic stroke; (2) There is a close relationship between C3, Hs-CRP and the volume of cerebral infarction and the degree of neurological deficits in patients with acute ischemic stroke, The degree of brain damage.