| 周文生,杜龙舟,王春雨,纪勇顺,郭庆敏.血清CysC、hs-CRP与急性脑梗死分型及并发医院感染的相关性探究[J].,2023,(14):2723-2727 |
| 血清CysC、hs-CRP与急性脑梗死分型及并发医院感染的相关性探究 |
| Correlation of Serum CysC and hs-CRP with Acute Cerebral Infarction Classification and Nosocomial Infection |
| 投稿时间：2023-02-27 修订日期：2023-03-23 |
| DOI：10.13241/j.cnki.pmb.2023.14.023 |
| 中文关键词: 急性脑梗死 胱抑素C 超敏C反应蛋白 TOAST分型 医院感染 |
| 英文关键词: Acute cerebral infarction Cystatin C Hypersensitive C-reactive protein TOAST typing Nosocomial infection |
| 基金项目:安徽省卫生健康委科研项目（AHWJ2021a025） |
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| 中文摘要: |
| 摘要 目的：探究血清胱抑素C（CysC）、超敏C反应蛋白（hs-CRP）与急性脑梗死TOAST分型及并发医院感染的相关性。方法：以2017年9月~2022年9月84例急性脑梗死患者（脑梗死组）及57例健康体检者（对照组）为研究对象，采用免疫比浊法检测受试者血清CysC水平，采用乳胶增强免疫比浊法检测其hs-CRP水平。分析血清CysC、hs-CRP水平与急性脑梗死TOAST分型及并发医院感染的关系。结果：本研究纳入病例中无不明原因性缺血性卒中（SUE）患者，主要包括大动脉粥样硬化型（LAA）患者37例、小动脉闭塞型（SAO）患者12例、心源性栓塞型（CE）患者31例、其他病因明确型缺血性卒中（SOE）患者4例。不同TOAST分型患者的血清CysC、hs-CRP水平对比，存在显著性差异（P<0.05）；CE组血清CysC、hs-CRP水平高于LAA组、SAO组、SOE组，LAA组血清CysC、hs-CRP水平高于SAO组、SOE组，SAO组血清CysC、hs-CRP水平高于SOE组（P<0.05）。根据NIHSS评分将脑梗死患者分为重度组18例、中度组29例、轻度组37例，不同严重程度脑梗死患者的血清CysC、hs-CRP水平均高于对照组，且重度组高于中度组、轻度组（P<0.05）；中度组的血清CysC水平高于轻度组（P<0.05）。血清CysC、hs-CRP水平与脑梗死患者NIHSS评分均呈正相关（P<0.05）。84例脑梗死患者伴发医院感染28例，其中上呼吸道感染13例、肺部感染8例、泌尿系统感染5例、其他2例。感染组中合并糖尿病、有侵入性操作、TOAST分型为CE型的人数比例高于未感染组，NIHSS评分及血清CysC、hs-CRP水平高于未感染组（P<0.05）。侵入性操作、NIHSS评分≥16分、TOAST分型为CE型及CysC、hs-CRP水平升高是急性脑梗死并发感染的危险因素（P<0.05）。结论：CE型急性脑梗死患者血清CysC、hs-CRP水平显著升高，与病情严重程度相关，且侵入性操作、NIHSS评分≥16分、TOAST分型为CE型及CysC、hs-CRP水平升高是急性脑梗死并发感染的危险因素。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the correlation of serum cystatin C (CysC) and hypersensitive C-reactive protein (hs-CRP) with acute cerebral infarction classification and nosocomial infection. Methods: 84 patients with acute cerebral infarction (cerebral infarction group) and 57 healthy subjects with physical examination (control group) from September 2017 to September 2022 were selected as the study subjects. Serum CysC level was detected by immunoturbidimetry and hs-CRP level was detected by latex-enhanced immunoturbidimetry. The relationship of serum CysC and hs-CRP levels with acute cerebral infarction classification and nosocomial infection was analyzed. Results: There were no patients with stroke of other undemonstrated etiology (SUE) in this study, and there were 37 patients with large-artery atherosclerosis (LAA), 12 patients with small artery occlusion (SAO), 31 patients with cardiogenic embolism (CE) and 4 patients with stroke of other demonstrated etiology (SOE). There were significant differences in serum CysC and hs-CRP levels among patients with different TOAST types (P<0.05). The levels of serum CysC and hs-CRP were higher in CE group than those in LAA group, SAO group and SOE group, were higher in LAA group than those in SAO group and SOE group and were higher in SAO group than those in SOE group (P<0.05). According to NIHSS score, the patients with cerebral infarction were divided into severe group (18 cases), moderate group (29 cases) and mild group (37 cases). Serum CysC and hs-CRP levels of patients with cerebral infarction of different severities were higher than those in control group, and the levels in severe group were higher than those in moderate group and mild group (P<0.05). The level of serum CysC in moderate group was higher than that in mild group (P<0.05). Serum CysC and hs-CRP levels were positively correlated with NIHSS score in patients with cerebral infarction (P<0.05). There were 28 cases of nosocomial infection among 84 patients with cerebral infarction, including 13 cases of upper respiratory tract infection, 8 cases of pulmonary infection, 5 cases of urinary system infection and 2 cases of other infections. The proportions of people with diabetes mellitus, invasive operation and TOAST typing of CE type in infected group were higher than those in uninfected group while the NIHSS score and serum CysC and hs-CRP levels were higher than those in uninfected group(P<0.05). Invasive operation, NIHSS score≥16 points, TOAST typing of CE type and increased CysC and hs-CRP levels were risk factors for acute cerebral infarction with infection(P<0.05). Conclusion: Serum CysC and hs-CRP levels are significantly increased in patients with acute cerebral infarction of CE type, which is correlated with the severity of disease. Invasive operation, NIHSS score≥16 points, TOAST typing of CE type and increased levels of CysC and hs-CRP are risk factors for acute cerebral infarction with infection. |
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