Clinical Study On Hs-CRP, LPA, FIB, D-D Predicting Progressive Cerebral Infarction

Background and purpose:Progressive cerebral infarction (PCI) refers to neurologic function defects still in continuous development 24 to 72 hours after acute cerebral infarction occurres, and reaches a peak in 3 - 5 days. It is difficult to reverse this pathological process with conventional clinical treatment. With high incidence, mortality and morbidity, it is a threat to human life and health. PCI is an intractable cerebrovascular disease, and early diagnosis is difficult, and it very easy to induce medical disputes.It has gained wide attention in recent years. There are multiple causes and risk factors of progressive cerebral infarction. It is closely associated with blood vessel narrowing, acute blood pressure drop, high blood sugar, and vascular inflammation after infection, high cholesterol, obesity, smoking and alcohol use, as well as other risk factors. Current research shows that serum high sensitive C-reactive protein(hs-CRP), lysophospholipid acid (LPA), fibrinogen (FIB), D Dimer (D-D)are related to the occurrence and development of progressive cerebral infarction, so it is important to improve prevention of progressive cerebral infarction and discover new risk factors to control PCI early. We discuss the relationship of hs-CRP, LPA, FIB, D-D to progressive cerebral infarction and analyse the associated risk factors of progressive cerebral infarction by detecting the levels of hs-CRP, LPA, FIB, D-D in blood, and provide a new paradigm for the prevention and cure of progressive cerebral infarction.methods:Choose acute cerebral infarction according to inclusion criteria in neurology ward of the First Affiliate Hospital of Henan University from March 2010 to December 2010. All of the patients were neurobehaviorally scored according to the U.S. national institutes of health stroke scale (NIHSS) on admission and hospitalization for 48 hours. If acute cerebral infarction patients,scores of 48 hours (NIHSS) were three points or more than the scores of admission or the quantitative index of nervous system symptoms worsen then acute cerebral infarction is defined as progressive cerebral infarction. A random sample of 40 cases of stable cerebral infarction was used as control group. 20 cases from progressive cerebral infarction were used as the observer group. Venous blood was extracted on admission and hospitalization at 24 and 48 hours to examine the levels of hs-CRP, LPA, FIB, and D-D in blood. Investigate the relationship of hs-CRP, LPA, FIB, D-D to progressive cerebral infarction by comparing relevant statistical analyses of the two groups of patient levels of hs-CRP, LPA, FIB, and D-D.Results:1. In the progressive cerebral infarction group, the patient levels of hs-CRP, LPA, FIB, and D-D are all higher than the stable cerebral infarction group on admission and hospitalization at 24 and 48 hours.2. Spearman correlation analysis found that the levels of hs-CRP, LPA, FIB, and D-D all positively correlated with progressive cerebral infarction neurologic deficits score at 48 hours (NIHSS). Correlation coefficients were (hs-CRP△r=0.956p=0.000 LPA※r=0.884 p=0.000 FIB☆r=0.685 p=0.000 D-D▽r=0.622 p=0.003), The correlation coefficient of hs-CRP and LPA is higher than FIB and D -D.3. In progressive cerebral infarction and stable cerebral infarction, serum high sensitive C-reactive protein (hs-CRP) levels are all sustained; however, the hs-CRP level of progressive cerebral infarction has a more significant increase.Conclusion:1. The rising levels of hs-CRP, LPA, FIB, and D-D may be a risk factor of progressive cerebral infarction. In high-risk patients with cerebral infarction, levels of hs-CRP, LPA, FIB, and D–D should be closely monitored to provide effective treatment.2. The correlations of hs-CRP, LPA, FIB, D-D in progressive cerebral infarction patients,neurologic deficits score at 48 hours (NIHSS) were all positive. This shows that if the level of hs-CRP, LPA, FIB, and D-D are higher, then the neural function defect degree is greater. Among them the correlation coefficient of hs-CRP and LPA is larger than FIB and D-D. The correlation coefficient of hs-CRP is the largest and it shows that if the acute cerebral infarction levels of hs-CRP and LPA are higher, then the neural function defect degree is greater, and prognosis is worse. The prognostic value towards progressive cerebral infarction of hs-CRP is better than LPA, FIB, and D-D.3. In progressive cerebral infarction and stable cerebral infarction patients, serum high sensitive C-reactive protein (hs-CRP) levels are all higher than normal. This shows that continued inflammation after acute cerebral infarction is likely one of its causes. Early, the hs-CRP of progressive cerebral infarction group has markedly increased compared to the stable cerebral infarction group. This shows that if the level of hs-CRP is higher, then the likelihood of a further aggravating illness is greater.