癫痫杂志

癫痫杂志

C 反应蛋白与卒中后癫痫认知功能障碍的相关性研究

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目的 研究卒中患者急性期血清 C 反应蛋白(C-reactive protein,CRP)水平的改变及其与卒中后癫痫认知功能障碍的相关性。 方法 纳入四川大学华西医院 2010 年 1 月—2016 年 6 月住院治疗的既往无癫痫病史,且随访确诊为卒中后癫痫发作的患者 96 例为研究对象,考察受试者入院后 7d 内且痫性发作前的高敏 CRP 水平。随访 2 年后以 6 条目筛选表(Six-item screener,SIS)考察患者是否存在认知功能障碍,以 Logistic 多因素回归分析 CRP 与卒中后癫痫认知功能障碍的相关性。 结果 研究纳入的 96 例卒中后癫痫患者中 24 例在 2 年随访期间出现认知功能障碍。伴发认知功能障碍的患者入院时 CRP 水平显著高于认知功能正常的患者(31.5±36.2 vs. 11.9±19.4,P=0.029),且以多因素分析校正相关混杂因素后这一趋势仍然存在[OR=1.021,95%CI(0.997,1.206),P=0.037]。 结论 研究首次发现卒中后急性期的 CRP 水平与卒中后癫痫伴随的认知功能障碍可能存在相关性,为探索此类患者认知损害的炎性预测因子提供了依据。但研究还需要在更大样本量,更严格排除众多 CRP 影响因素的情况下进一步证实其准确性。

Objectives This study aims to examine the possible association between C-reactive protein (CRP) concentration and cognitive impairment in patients with post-stroke epilepsy. Methods Patients with post-stroke epilepsy admitted to Western China Hospital from January 2010 to June 2016 were consecutively enrolled in our study. CRP levels were assessed within one week of stroke onset, and then correlated with cognitive status assessed two years after stroke using the Six-Item Screener. Results Among the 96 patients with post-stroke epilepsy who included in our study, 24 patients were found to have cognitive impairment during the two years follow-up period. Our data showed a significant association between CRP levels and cognitive performance in these patients (31.5±36.2 vs. 11.9±19.4, P=0.029). In addition, this association persisted even after adjusting for potential confounders[OR=1.021, 95%CI (0.997, 1.206), P=0.037]. Conclusions Following ischemic stroke, higher CRP levels is associated with subsequent cognitive decline in patients with epilepsy. Association and prospective studies in larger sample size are needed in order to validate our findings, especially studies in which baseline CRP level and CRP level during follow-up are closely monitored.

关键词: C 反应蛋白; 卒中; 癫痫; 认知功能障碍

Key words: C-reactive protein; Cognitive impairment; Epilepsy; Ischemic stroke

引用本文: 郭建, 慕洁, 郭毅佳, 周东, 何俐. C 反应蛋白与卒中后癫痫认知功能障碍的相关性研究. 癫痫杂志, 2018, 4(5): 377-380. doi: 10.7507/2096-0247.20180061 复制

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