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目的探讨血浆超敏C-反应蛋白(hs-CRP)及D-二聚体(D-D)水平在进展性缺血性卒中患者发病中的意义。方法选取2012年3月至2013年5月神经内科收治的首发急性缺血性卒中患者135例,其中进展性缺血性卒中(progressive ischemic stroke,PIS)组42例,非进展性缺血性卒中(NPIS)组93例以及对照组(健康体检者)40例,检测患者在发病后第1天、第3天、第7天及健康体检者一次空腹血浆hs-CRP及D-D水平,在发病3 d内行颈动脉彩超检查。结果 PIS组患者入院24 h时hs-CRP水平较对照组明显增高(P<0.05),较NPIS组有所增高,但无统计学差异(P>0.05);3 d时达到高峰,7 d时有所下降,但两个时间点仍显著高于本组24 h及对照组,也高于NPIS组hs-CRP水平(P均<0.01)。PIS组患者入院24 h血浆D-D水平较对照组及NPIS组均明显增高(P<0.01,P<0.05);3 d及7 d一直维持在较高水平,显著高于对照组及NPIS组(P<0.01,P<0.05)。PIS组颈动脉狭窄率稍高于NPIS组,但差异无统计学意义(P<0.05)。结论患者血浆hs-CRP及D-D水平与缺血性卒中是否进展关系密切,对预测患者病情进展有重要的临床意义。
Objective To investigate the significance of plasma hs-CRP and D-D levels in the pathogenesis of patients with progressive ischemic stroke. Methods Thirty-five patients with acute ischemic stroke admitted to Department of Neurology from March 2012 to May 2013 were enrolled in this study. Forty-two patients with progressive ischemic stroke (PIS), 42 patients with non-progressive ischemic stroke (NPIS) group and control group (40 healthy subjects). The fasting plasma hs-CRP and DD levels were detected on the 1st, 3rd and 7th day after the onset of disease in healthy volunteers d line carotid ultrasound examination. Results The level of hs-CRP in PIS group was significantly higher than that in control group at 24 h (P <0.05), but higher than that in NPIS group (P> 0.05) But both time points were still significantly higher than the 24 h group and the control group, but also higher than the hs-CRP level in NPIS group (all P <0.01). The level of plasma DD in PIS group was higher than that in control group and NPIS group at 24 hours after admission (P <0.01, P <0.05), and remained high at 3 and 7 days, which was significantly higher than that in control group and NPIS group <0.01, P <0.05). The carotid stenosis rate in PIS group was slightly higher than that in NPIS group, but the difference was not statistically significant (P <0.05). Conclusion The plasma levels of hs-CRP and D-D in patients with ischemic stroke are closely related to the progress of the prognosis of patients with an important clinical significance.