Ye Zusen, Zhang Zhizhong, Zhang Hao, Hao Yonggang, Zhang Jun, Liu Wenhua, Xu Gelin, Liu Xinfeng
Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, Jiangsu, China; Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
J Stroke Cerebrovasc Dis. 2017 Mar;26(3):618-626. doi: 10.1016/j.jstrokecerebrovasdis.2016.11.016. Epub 2016 Dec 12.
Our objective is to investigate whether C-reactive protein (CRP) and homocysteine (Hcy) levels in the acute phase of large-artery atherosclerotic stroke predict long-term functional disability and recurrent vascular events.
Patients with first-ever large-artery atherosclerotic ischemic stroke were prospectively registered in the Nanjing Stroke Registry Program between January 2012 and June 2014. Venous blood samples were collected within 2 weeks after the index stroke. Patients were followed up for 1 year. The Kaplan-Meier method was performed in survival analysis. Multiple logistic regression analysis and Cox proportional hazard model were applied to identify predictors of functional disability and recurrent vascular events, respectively.
A total of 625 eligible patients (458 males) were evaluated. During the 1-year follow-up period, 63 patients suffered recurrent vascular events. An elevated CRP level is an independent predictor of poor functional disability at 1 year (P for trend = .002), in both males (P for trend = .017) and females (P for trend = .042). Hcy showed no relationship with functional disability. No significant relationship between CRP and Hcy levels and recurrent vascular events was found in total patients in multiple models. Stratified by sex, high Hcy levels were associated with recurrent vascular events in females (P for trend = .036) but not in males.
Elevated CRP levels are associated with poor functional disability in patients with large-artery atherosclerotic stroke at 1 year, and Hcy is a relatively moderate predictor of recurrent vascular events in female patients with large-artery atherosclerotic stroke at 1 year.
我们的目的是研究大动脉粥样硬化性卒中急性期的C反应蛋白（CRP）和同型半胱氨酸（Hcy）水平是否可预测长期功能残疾和复发性血管事件。
2012年1月至2014年6月期间，首次发生大动脉粥样硬化性缺血性卒中的患者被前瞻性纳入南京卒中注册项目。在索引卒中后2周内采集静脉血样本。对患者进行1年的随访。生存分析采用Kaplan-Meier法。分别应用多元逻辑回归分析和Cox比例风险模型来确定功能残疾和复发性血管事件的预测因素。
共评估了625例符合条件的患者（458例男性）。在1年的随访期内，63例患者发生了复发性血管事件。CRP水平升高是1年时功能残疾不良的独立预测因素（趋势P值=0.002），在男性（趋势P值=0.017）和女性（趋势P值=0.042）中均如此。Hcy与功能残疾无相关性。在多个模型中，总体患者中CRP和Hcy水平与复发性血管事件之间未发现显著相关性。按性别分层，高Hcy水平与女性复发性血管事件相关（趋势P值=0.036），而与男性无关。
CRP水平升高与大动脉粥样硬化性卒中患者1年时的功能残疾不良相关，Hcy是大动脉粥样硬化性卒中女性患者1年时复发性血管事件的相对中等程度的预测因素。
