C-反应蛋白、白介素-6在醒后卒中的研判价值

The Diagnostic Value of C-Reactive Protein and Interleukin-6 in Post-Wake Stroke

摘要: 目的：探讨醒后卒中(WUS)患者血清C-反应蛋白(CRP)、白介素-6(IL-6)水平与病情严重程度的相关性，分析其诊断WUS的价值。方法：选择2020年1月至2021年6月我院老年病科和神经内科收治的153例WUS患者(WUS组)和72例体检者(对照组)，根据美国(NHISS)评分将WUS组分为轻度亚组(43例)、中度亚组(69例)和重度亚组(41例)，根据脑梗死大小分为大梗死亚组(35例)、小梗死亚组(80例)、腔隙性梗死亚组(38例)。检测血清CRP、IL-6水平，分析WUS发病因素以及CRP、IL-6诊断WUS的价值。结果：WUS组血清CRP、IL-6水平均高于对照组(P < 0.05)。重度亚组、中度亚组患者血清CRP、IL-6水平高于轻度亚组(P < 0.05)，大梗死亚组、小梗死亚组患者血清CRP、IL-6水平高于腔隙性梗死亚组(P < 0.05)。阻塞性睡眠呼吸暂停综合征，高水平CRP、高水平IL-6是WUS的危险因素(P < 0.05)。CRP、IL-6诊断WUS的曲线下面积为0.743、0.683，联合CRP、IL-6诊断为0.895，高于单独CRP、IL-6 (z = 4.288、5.022，P < 0.05)。结论：WUS患者血清CRP、IL-6水平均增高，且与梗死面积增大、神经缺损加重有关，可作为WUS诊断的辅助指标。

Abstract: Objective: To investigate the correlation between the levels of C-reactive protein (CRP) and inter-leukin-6 (IL-6) and the severity of disease in patients with wake-up stroke (WUS), and to analyze the value of the diagnosis of WUS. Methods: 153 WUS patients (WUS group) admitted to the de-partment of Neurology of our hospital and 72 physical examination subjects (control group) from January 2020 to June 2021 were selected. The WUS group was divided into mild subgroup (43 cas-es), moderate subgroup (69 cases) and severe subgroup (41 cases) according to the national insti-tutes of health stroke scale (NHISS) score. According to the size of cerebral infarction, they were di-vided into major infarction subgroup (35 cases), minor infarction subgroup (80 cases) and lacunar infarction subgroup (38 cases). Serum CRP and IL-6 levels were detected to analyze the pathogene-sis of WUS and the value of CRP and IL-6 in the diagnosis of WUS. Results: The levels of serum CRP and IL-6 in WUS group were higher than those in control group (P < 0.05). The serum levels of CRP and IL-6 in severe and moderate subgroups were higher than those in mild subgroup (P < 0.05), and the levels of CRP and IL-6 in major and minor subgroups were higher than those in lacunar subgroup (P < 0.05). Obstructive sleep apnea syndrome, high levels of CRP and IL-6 were risk fac-tors for WUS (P < 0.05). The area under the curve of CRP and IL-6 in the diagnosis of WUS were 0.743 and 0.683, and the combined diagnosis of CRP and IL-6 was 0.895, which was higher than that of CRP and IL-6 alone (z = 4.288 and 5.022, P < 0.05). Conclusion: The serum CRP and IL-6 levels of WUS patients are increased, which are related to the increase of infarct size and the aggravation of nerve defect, and can be used as auxiliary indicators for the diagnosis of WUS.