| Objective:1Clear the changes of hs-CRP and UAER in patients with Lacunar infarction.2Explore the possible mechanisms of the inflammatory reactions and microvascular endothelial injury in the occurrence and development of lacunar infarction.3Explore whether the hs-CRP. UAER as an indicator of inflammation and endothelial damage prediction lacunar infarction prognosis.Methods:Randomly selected60patients with lacunar infarction who are hospitalized in my department from December2012to October2013(including type2diabetes and lacunar infarction20cases, hypertension and lacunar infarction20cases, type2diabetes and hypertension and lacunar infarction20cases) as the Lacunar infarction group, aged45-87years old,average age (68.1167±9.75478). Another60patients were randomly selected as without lacunar infarction group (including20cases of type2diabetes,20cases of hypertension,20cases of type2diabetes and hypertension),aged44-87years old, average age(64.700±10.93641). All of those patients are without acute myocardial infarction, liver and kidney dysfunction, nephrotic syndrome, infection of urinary tract, respiratory, digestive, circulatory, and nervous system, vasculitis, cancer, diabetic ketoacidosis. diabetic hyperosmolar state, malignant hypertension, thyroid function hyperthyroidism, autoimmune diseases, and the recent history of trauma and surgery. The diagnostic criteria for lacunar infarction is based on the "All kinds of cerebrovascular disease diagnostic criteria" which is amend in the Fourth National Conference Of Cerebrovascular Disease. The diagnostic criteria for hypertension is in accordance with the2005Chinese Hypertension Prevention Guide (Revised Edition). Diagnosis of type2diabetes, according to the1999Diabetes diagnosis and classification criteria promulgated by WHO. All subjects were taken to detect the blood, blood pressure, lipids, fasting glucose, HBA1C, liver and kidney function, electrolytes, ECG, high-sensitivity C-reactive protein,24-hour urinary albumin quantitative MRI and other tests. The data obtained is statisticed by SPSS17.0statistical package, measurement data using t test.count data using the x2test statistic. All data were analyzed by Logistic regression analysis, linear regression and multiple linear regression and correlation statistics when necessary.Results:1The hs-CRP level (1.2113±0.72716) in patients with lacunar infarction and the level (0.7135±0.47924) in patients without lacunar infarction the difference is statistically significant (P<0.001), lacunar infarction group the UAER (0.9642±0.96614) g/24h compare with the UAER(0.3219±0.55525) g/24h in patients without lacunar infarction the the difference is statistically significant (P<0.001).2In the lacunar infarction group, patients with single stems chamber hs-CRP level(0.9119±0.67407) and in patients with multiple lacunar infarction level of hs-CRP (1.3726±0.771105) difference is statistically significant (P=0.018), single chamber terrier patient’s UAER(0.4824±0.60895) compare with patients with lacunar group multiple UAER(1.2236±1.02799) the difference is statistically significant (P=0.004).3With type2diabetes patients hs-CRP levels (0.6320±0.38707) and type2diabetes mellitus lacunar group hs-CRP level (0.98729±0.4121) difference statistically significant (P=0.043), type2diabetes UAER (0.2700±0.28908) and type2diabetes mellitus lacunar group of UAER(1.0585±0.82156) there was a significant difference (P＜0.001); hypertension group hs-CRP levels (0.7640±0.46027) with hypertension and lacunar group hs-CRP levels (1.1630±0.59413) were significantly different (P=0.023), hypertension group UAER(0.2074±0.1077) compared with hypertension had lacunar group UAER(0.96543±0.7864) statistically significant (P=0.046):hypertension and type2diabetes hs-CRP levels (0.9250±0.56911) with hypertension and type2diabetes with lacunar group hs-CRP levels (1.5140±0.82169) were significantly different (P=0.012) difference, hypertension and type2diabetes UAER (0.7035±0.60020) there was significant difference (P=0.009) with hypertension patients with type2diabetes lacunar group of UAER(1.3625±0.88980).4Correlation analysis of hs-CRP and UAER in patients with lacunar infarction simple linear correlation Pearson correlation coefficient was0.311, P＜0.001, multiple linear regression and correlation results same with the simple correlation between a positive correlation coefficient R=0.141, P=0.028.5In this study the lumen gap in patients with lacunar infarction of the hs-CRP and UAER were significantly greater than in the without lacunar infarction group, with lacunar infarction as the dependent variable in Logistic regression analysis, the final step as the results of the analysis, the final step into the equation of variable is the hs-CRP, UAER. triglycerides into the equation of the three variables are the partial regression coefficient R>0, risk OR are>1, the three are the risk factors of acute lacunar cerebral infarction.6. Patients with lacunar cerebral infarction the N1HSS score was a positive correlation with hs-CRP, UAER.Conclusion:1.The hs-CRP levels and UAER with Lacunar cerebral infarction patients were significantly higher than that of without lacunar cerebral infarction group, suggests that lacunar cerebral infarction may relate to the micro vascular endothelial injury and inflammation.2.Patients with multiple lacunar cerebral infarction the hs-CRP, UAER were higher than single sex lacunar cerebral infarction patients, patients with lacunar cerebral infarction the NIHSS score was positively correlated with hs-CRP, UAER, indicate the degree of lacunar infarction maybe associated with hs-CRP and UAER related inflammation and endothelial injury.3.In patients with lacunar infarction the UAER and hs-CRP levels were positively correlated, suggesting that vascular endothelial injury degree of inflammation associated with microvascular endothelium.4. High hs-CRP levels (>0.75mg/L) and albuminuria (>300mg/24h), high triglycerides were the risk factors of lacunar cerebral infarction, and hypertension, type2diabetes, lacunar cerebral infarction were risk factors of high hs-CRP levels and albuminuria, whether in the clinical work by testing the level of hs-CRP and UAER evaluation in patients with hypertension, type2diabetes risk of lacunar cerebral infarction and the prognosis of patients with lacunar cerebral infarction.5. Further study is necessary whether hs-CRP and UAER is an independent risk factor for ischemic stroke. |
PDF Full Text Request