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目的探讨青年缺血性卒中病因、发病机制与超敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)的关系。方法选择258例18～45岁青年缺血性卒中患者,按中国缺血卒中分型(Chinese ischemic stroke subclassification,CISS)对病因和发病机制进行分型;选择158名18～45岁的门诊健康体检者作为对照。采用免疫比浊法对患者和对照组血清hs-CRP水平进行测定。结果青年缺血性卒中患者hs-CRP水平明显高于对照组[(4.83±3.53)mg/Lvs.(1.93±1.38)mg/L,t=5.11,P<0.001]。不同病因其hs-CRP水平不同,心源性卒中hs-CRP水平最高,为(5.68±3.67)mg/L,其次依次为大动脉粥样硬化组[(3.61±3.49)mg/L]、穿支动脉疾病组[(3.14±1.81)mg/L]、其他病因组[(2.89±2.90)mg/L]和病因不确定组[(2.83±3.46)mg/L],组间差异有统计学意义(P<0.05);其中大动脉粥样硬化组中不同发病机制其hs-CRP水平不同,动脉-动脉栓塞组hs-CRP水平最高,为(5.67±5.40)mg/L,其次依次为混合机制组[(3.99±4.42)mg/L]、低灌注/栓子清除下降组[(3.96±3.87)mg/L]和载体动脉(斑块或血栓)阻塞穿支动脉组[(2.29±2.17)mg/L],组间差异有统计学意义(P<0.05)。结论青年缺血性脑卒中的病因复杂多变,血浆高hs-CRP水平与青年脑梗死的发生、病因及发病机制有一定关联,需进一步研究。
Objective To investigate the relationship between the pathogenesis and high sensitive C-reactive protein (hs-CRP) in young patients with ischemic stroke. Methods A total of 258 young adults with ischemic stroke aged 18-45 years were enrolled in this study. The etiology and pathogenesis were classified according to Chinese ischemic stroke subclassification (CISS). Fifty-eight outpatients aged 18-45 years As a control. Serum hs-CRP levels in patients and controls were determined by immunoturbidimetry. Results The hs-CRP level in young patients with ischemic stroke was significantly higher than that in the control group [(4.83 ± 3.53) mg / L vs (1.93 ± 1.38) mg / L, t = 5.11, P <0.001). The levels of hs-CRP in different etiologies were different, and the highest level of hs-CRP in stroke was (5.68 ± 3.67) mg / L, followed by that of the atherosclerosis group (3.61 ± 3.49 mg / L) Arterial disease group [(3.14 ± 1.81) mg / L], other etiological group [(2.89 ± 2.90) mg / L] and etiological group [(2.83 ± 3.46) mg / L], the difference was statistically significant (P <0.05). The hs-CRP levels of different pathogenesis in large atherosclerosis group were different. The hs-CRP level in arterial-arterial embolization group was the highest (5.67 ± 5.40) mg / L, followed by the mixed mechanism group [(3.99 ± 4.42) mg / L], [3.96 ± 3.87 mg / L] in the low perfusion / embolectomy group, and 2.29 ± 2.17 mg in the arterial artery (plaque or thrombus) / L], the difference between the groups was statistically significant (P <0.05). Conclusions The etiology of ischemic stroke in youth is complicated and variable. The level of plasma hs-CRP is correlated with the occurrence, etiology and pathogenesis of cerebral infarction in young patients. It needs further study.