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目的:观察急性脑梗死(CI)患者血清中总同型半胱氨酸(tHcy)和超敏C-反应蛋白(hs-CRP)水平同疾病严重程度以及两者之间的关系。方法:采用高效液相色谱-荧光检测定量分析和免疫散射比浊法定量分析检测110例CI组、37例其他神经系统疾病组和105名正常对照组的tHcy和hs-CRP。结果:CI组tHcy水平同其他神经系统疾病组比较差异无统计学意义(P>0.05),而高于正常对照组水平(P<0.05);CI组hs-CRP水平高于其他对照组(P<0.05)。所有CI患者依据NIHSS评分再分为≤5分、5～15分以及≥15分3个亚组。所观察CI患者tHcy平均值(22.24±16.59)μmol·L~(-1),3组tHcy差异无统计学意义(P>0.05);hs-CRP平均值(3.29±2.51)mg·L~(-1),3组间hs-CRP水平比较差异有显著统计学意义(P<0.01);tHcy水平与hs-CRP水平无相关性(P>0.05)。结论:高tHcy与高hs-CRP是脑血管病的危险因素;高tHcy并不是CI的特异性指标,在其他神经系统疾病中也可升高;hs-CRP水平同疾病的严重程度相关;两者的升高可能存在不同的机制。
Objective: To observe the relationship between serum total homocysteine (tHcy) and high-sensitivity C-reactive protein (hs-CRP) levels in patients with acute cerebral infarction (CI) and the severity of the disease and their relationship. Methods: The levels of tHcy and hs-CRP in 110 patients with CI, 37 patients with other neurological diseases and 105 normal controls were detected by high performance liquid chromatography-fluorescence detection and immuno-nephelometry. Results: The level of tHcy in CI group was not significantly different from other neurological diseases (P> 0.05), but higher than that in normal control group (P <0.05). The level of hs-CRP in CI group was higher than that in other control groups <0.05). According to NIHSS score, all CI patients were further subdivided into 3 subgroups: ≤5 points, 5 ~ 15 points and ≥15 points. The mean value of tHcy in CI patients was (22.24 ± 16.59) μmol·L -1, no significant difference was found in tHcy among the three groups (P> 0.05). The mean value of hs-CRP was (3.29 ± 2.51) mg · L ~ -1). There was significant difference in hs-CRP levels between the three groups (P <0.01). No correlation was found between tHcy level and hs-CRP level (P> 0.05). Conclusions: High tHcy and high hs-CRP are risk factors of cerebrovascular disease. High tHcy is not the specific index of CI and may be elevated in other nervous system diseases. The level of hs-CRP is related to the severity of the disease. There may be different mechanisms for the rise of people.