JAHA:高敏C反应蛋白与缺血性卒中或短暂性脑缺血发作患者预后之间的关系

2022-07-03 MedSci原创 MedSci原创

缺血性卒中或短暂性脑缺血发作后72小时至8天内检测到的hsCRP水平升高与1年卒中复发风险增加相关。

大量的证据强调了炎症在动脉粥样硬化和心脑血管疾病的病理生理学中的关键作用。大多数既往的研究表明,高敏C反应蛋白(hsCRP)是心血管研究中关注最多的细胞因子之一,在卒中复发中发挥了关键作用。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,该研究的目的是探究hsCRP与卒中发病后预后之间的关系。

在这项预先设定的前瞻性亚研究中,共有9438例测量了hsCRP的急性缺血性卒中或短暂性脑缺血发作患者被纳入。根据发病时间将患者分为3组(<24小时、24-72小时、72小时-8天)。该研究的结局包括1年内卒中复发和合并血管事件,依赖性或死亡定义为1年修改Rankin量表评分为3-6分。研究人员采用Cox比例风险和Logistic回归模型分析hsCRP与不同组预后之间的关系。

24小时内、24-72小时、72-8天三组患者的hsCRP中位水平分别为2.01、1.72和1.72mg/L(P<0.05)。与最低四分位数相比,最高四分位数的患者在72小时内卒中复发风险增加(<24小时:调整后风险比[HR]为1.57[95%CI为1.05-2.35],P=0.03;24-72小时:调整后的HR为1.60[95%CI为1.18-2.17],P=0.003)。在急性卒中治疗分级中进一步调整Org10172试验后相关性有所减弱(<24小时:调整后HR为1.51[95%CI为1.01-2.27];P=0.05;24-72小时:调整后HR为1.55[95%CI为1.14-2.10];P=0.01)。这种关联仅存在于大动脉粥样硬化患者(校正HR为1.68[95%CI为1.06-2.64];P=0.03)。然而,在72小时至8天的hsCRP水平中未发现相关性。此外,24-72小时的hsCRP水平与功能不良结局风险增加相关。

由此可见,缺血性卒中或短暂性脑缺血发作后72小时至8天内检测到的hsCRP水平升高与1年卒中复发风险增加相关。

原始出处:

Yu Wang.et al.Association Between High‐Sensitivity C‐Reactive Protein and Prognosis in Different Periods After Ischemic Stroke or Transient Ischemic Attack.JAHA.2022.https://www.ahajournals.org/doi/10.1161/JAHA.122.025464

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content=<a href='/topic/show?id=4eca5598c7' target=_blank style='color:#2F92EE;'>#C反应蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5598, encryptionId=4eca5598c7, topicName=C反应蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20b5274, createdName=JR19860219, createdTime=Sun Jul 03 06:31:53 CST 2022, time=2022-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1614820, encodeId=be641614820c9, content=<a href='/topic/show?id=49d810240513' target=_blank style='color:#2F92EE;'>#高敏C反应蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102405, encryptionId=49d810240513, topicName=高敏C反应蛋白)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=61fa19545213, createdName=1249884fm93暂无昵称, createdTime=Sun Jul 03 06:31:53 CST 2022, time=2022-07-03, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1893520, encodeId=d3d518935209f, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu May 25 05:31:53 CST 2023, time=2023-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806525, encodeId=716c180652585, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, 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CST 2022, time=2022-07-03, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1893520, encodeId=d3d518935209f, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Thu May 25 05:31:53 CST 2023, time=2023-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806525, encodeId=716c180652585, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, 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content=<a href='/topic/show?id=4eca5598c7' target=_blank style='color:#2F92EE;'>#C反应蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5598, encryptionId=4eca5598c7, topicName=C反应蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20b5274, createdName=JR19860219, createdTime=Sun Jul 03 06:31:53 CST 2022, time=2022-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1614820, encodeId=be641614820c9, content=<a href='/topic/show?id=49d810240513' target=_blank style='color:#2F92EE;'>#高敏C反应蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102405, encryptionId=49d810240513, topicName=高敏C反应蛋白)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=61fa19545213, createdName=1249884fm93暂无昵称, createdTime=Sun Jul 03 06:31:53 CST 2022, time=2022-07-03, status=1, ipAttribution=)]
    2022-07-03 zhaohui6731
  7. 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  8. 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