摘要
目的 分析急性缺血性脑卒中(AIS)患者初始血清高敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)和静脉血降钙素原(PCT)水平与卒中后日间过度嗜睡(EDS)的相关性。方法 回顾性分析177例AIS患者,在出院后2周时采用Epworth嗜睡量表(ESS)进行评分,将ESS<9分者归入无EDS组,将ESS≥9分者归入EDS组,在EDS组内又按照9≤ESS<14、14≤ESS<20、ESS≥20标准分为轻度、中度、重度嗜睡组3个亚组。分别对比2组以及EDS组内3个亚组的基线临床资料和发病初始血清hs-CRP、Hcy和静脉血PCT水平。运用二元logistic回归分析方法分析AIS患者初始血清hs-CRP、Hcy和静脉血PCT水平与EDS的相关性。结果 177例患者中,EDS的患病率约为28.8%(51/177)。EDS组患者的血清hs-CRP、Hcy水平和静脉血PCT水平显著高于无EDS组(P<0.05)。对EDS组中的轻度嗜睡、中度嗜睡和重度嗜睡3个亚组分析表明,ESS评分的增加与血清hs-CRP(F=8.203,P=0.0 009)和Hcy(F=7.680,P=0.0 013)水平的升高存在显著相关性,二元多因素logistic回归分析结果显示血清hs-CRP(OR=1.922,95%CI:1.264~2.922,P=0.002)和Hcy(OR=1.338,95%CI:1.062~1.685,P=0.013)水平升高是EDS的独立危险因素。结论 AIS后EDS患者血清中hs-CRP、Hcy和静脉血PCT的水平均显著升高,且血清hs-CRP和Hcy水平的升高与EDS严重程度呈正相关,是EDS的独立危险因素。提示炎症反应和氧化应激可能参与了AIS患者EDS的发生发展。
Objective To analyze the correlation between the initial serum levels of hypersensitive C-reactive protein(hs-CRP),homocysteine(Hcy),and the venous blood level of procalcitonin(PCT)and excessive daytime sleepiness(EDS)in patients with acute ischemic stroke.Methods 177 patients with AIS were retrospectively analyzed.The Ep-worth Sleepiness Scale(ESS)was used to score 2 weeks after discharge.Patients with an ESS<9 were categorized into the non-EDS group,while those with an ESS≥9 were categorized into the EDS group.In the EDS group,they were di-vided into 3 subgroupsbased on their ESS scores:mild(9≤ESS<14),moderate(14<ESS<20),and severe sleepiness(ESS≥20)groupsand.The baseline clinical data,serum hs-CRP,Hcy and venous PCT levels at the beginning of the dis-ease were compared between the two groups and three subgroups in the EDS group.Binary logistic regression analysis was used to analyze the correlation between initial serum hs-CRP,Hcy and venous PCT levels and EDS in AIS patients.Results Among 177 patients,the prevalence of EDS was approximately 28.8%(51/177).The serum hs-CRP,Hcy lev-els and venous PCT levels in patients in the EDS group were significantly higher than those in the non-EDS group(P<0.05).Analysis of three subgroups of mild sleepiness(n=16),moderate sleepiness and severe sleepiness in the EDS group showed that the increase in ESS score was significantly correlated with the increase in serum hs-CRP(F=8.203,P=0.0009)and Hcy(F=7.680,P=0.0013)levels.Binary multivariate logistic regression analysis showed that ele-vated serum hs-CRP(OR=1.922,95%CI:1.264~2.922,P=0.002)and Hcy(OR=1.338,95%CI:1.062~1.685,P=0.013)levels were independent risk factors for EDS.Conclusion The serum hs-CRP,Hcy and venous PCT levels in patients with EDS after AIS are significantly increased,and the increase of serum hs-CRP and Hcy levels is positively related with the severity of EDS and are independent risk factors for EDS.It suggests that inflammatory reaction and oxidative stress may be involved in the occurrence and development of EDS in AIS patients.
作者
陈少元
CHEN Shaoyuan(Department of Neurology,Chinese People’s Liberation Army 32397 Troops Hospital,Baicheng,Jilin 137000,China)
出处
《中国实验诊断学》
2025年第8期874-879,共6页
Chinese Journal of Laboratory Diagnosis
关键词
卒中
白日过度嗜睡
高敏C反应蛋白
降钙素原
同型半胱氨酸
Stroke
Excessive daytime sleepiness
Highly sensitive C reactive protein
Procalcitonin
Homocysteine
作者简介
通信作者:陈少元,510555539@qq.com。
