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超敏C反应蛋白和同型半胱氨酸水平在老年脑梗死诊断及功能预后评估中的预测价值。

The value of ultrasensitive C-reactive protein and homocysteine levels in predicting the diagnosis and functional prognostic assessment of cerebral infarction in the elderly.

作者信息

Tao Xiao-Ming, Liu Wei, Chen Xiang-Hua, Ding Meng, Zong Chun-Guang

机构信息

Department of Clinical Laboratory, Affiliated Hospital of Chengde Medical College, Chengde, China.

Department of Internal Neurology, Affiliated Hospital of Chengde Medical College, Chengde, China.

出版信息

Int J Neurosci. 2025 Mar;135(3):265-271. doi: 10.1080/00207454.2023.2298374. Epub 2024 Feb 3.

Abstract

OBJECTIVE

To evaluate the diagnostic value of ultrasensitive C-reactive protein (hs-CRP) and homocysteine (Hcy) for cerebral infarction.

METHODS

260 elderly patients with cerebral infarction were recruited and assigned to the stroke group, and 60 healthy elderly were identified as controls and included in the normal group. Serum samples of all subjects were collected at the time of admission for the determination of hs-CRP and Hcy levels.

RESULTS

Patients with cerebral infarction exhibited significantly higher hs-CRP and Hcy levels than healthy controls. the patients were then categorized into mild-moderate and moderate-severe groups according to the National Institutes of Health Stroke Scale (NIHSS) score. No significant association was identified between Hcy levels and infarction severity, while more severe infarction was potentially related to higher hs-CRP levels, as evidenced by the higher hs-CRP levels observed in patients with moderate-severe infarction versus a milder severity. Patients with disease recurrence within 2 years were also included in a recurrence group, while those without recurrence were in a non-recurrence group. Results showed that patients with or without disease recurrence had similar hs-CRP and Hcy levels.

CONCLUSION

In elderly patients with cerebral infarction, serum hs-CRP, and Hcy levels are potentially promising markers for the diagnosis of stroke, assessment of stroke severity, and prediction of functional recovery. hs-CRP provides more benefits in diagnosing cerebral infarction, and Hcy is more conducive to the assessment of stroke severity and prediction of functional recovery. Combined detection of the two indices did not offer additional benefits in diagnostic and predictive efficacy.

摘要

目的

评估超敏C反应蛋白(hs-CRP)和同型半胱氨酸(Hcy)对脑梗死的诊断价值。

方法

招募260例老年脑梗死患者并将其分配至卒中组,同时确定60例健康老年人作为对照组纳入正常组。在所有受试者入院时采集血清样本,以测定hs-CRP和Hcy水平。

结果

脑梗死患者的hs-CRP和Hcy水平显著高于健康对照组。然后根据美国国立卫生研究院卒中量表(NIHSS)评分将患者分为轻度-中度组和中度-重度组。未发现Hcy水平与梗死严重程度之间存在显著关联,而更严重的梗死可能与较高的hs-CRP水平有关,中度-重度梗死患者的hs-CRP水平高于轻度梗死患者即证明了这一点。将2年内疾病复发的患者纳入复发组,未复发的患者纳入非复发组。结果显示,疾病复发患者与未复发患者的hs-CRP和Hcy水平相似。

结论

在老年脑梗死患者中,血清hs-CRP和Hcy水平可能是用于诊断卒中、评估卒中严重程度及预测功能恢复的有前景的标志物。hs-CRP在诊断脑梗死方面更具优势,而Hcy更有助于评估卒中严重程度及预测功能恢复。联合检测这两个指标在诊断和预测效能方面并未提供额外优势。

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