关键词: 急性脑梗死, 血清淀粉样蛋白A, C-反应蛋白, 美国国立卫生研究院卒中量表评分

Abstract: Objective To investigate the clinical and prognostic value of serum amyloid A(SAA) in patients with acute ischemic stroke. Methods Blood samples were collected from the patients within the 24 h after admission. Enzyme-linked immunosorbent assay(ELISA) was used to determinate SAA levels among 100 cases of acute stroke patients before and after 21-day treatment and CRP was detected by immunoturbidimetry. Fifty healthy volunteers served as the control group. All patients were given comprehensive treatment. On admission and after 21-day treatment, the National Institutes of Health Stroke Scale(NIHSS) was employed to provide a quantitative measure of stroke-related neurologic deficit. Furthermore, correlation between SAA levels and change in NIHSS score before and after treatment was analyzed using the Pearson correlation coefficient in order to explore the association of SAA levels with clinical picture and prognostic value in patients with acute cerebral infarction. Results SAA levels were significantly higher in acute cerebral infarction patients before treatment(18.05±6.77) mg/L than in the patients after treatment(7.81±2.66) mg/L and in the control group(7.49±4.49) mg/L, respectively(P<0.01). CRP levels were significantly higher in acute cerebral infarction patients before treatment (15.05±4.32) mg/L than in the patients after treatment(6.05±2.20) and in the control group(5.5±3.34) mg/L, respectively(P<0.01). After treatment, NIHSS score decreased significantly at 21 d (11.07±4.2 vs 7.78±2.89, P<0.05). The SAA levels at the acute stage showed a positive correlation with the net change in NIHSS score(r=0.612, P<0.05). Conclusion Patients with acute cerebral infarction have significantly increased SAA and CRP levels, which both indicate active disease. The SAA levels, but not CRP levels, are positively correlated with the net change in NIHSS score, suggesting that SAA may predict the prognosis of patients with acute cerebral infarction and has better prognostic value than CRP.

Key words: acute cerebral infarction, serum amyloid A, C-reactive protein, National Institutes of Health Stroke Scale(NIHSS)