C-reactive protein and long-term ischemic stroke prognosis.
C-reactive protein and long-term ischemic stroke prognosis.
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C反应蛋白和长期缺血性中风预后。
DOI：
10.1016/j.jocn.2013.06.015
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发表时间：
2014-04
期刊：
影响因子：
--
通讯作者：
Barr TL
中科院分区：
文献类型：
--
作者：
VanGilder RL;Davidov DM;Stinehart KR;Huber JD;Turner RC;Wilson KS;Haney E;Davis SM;Chantler PD;Theeke L;Rosen CL;Crocco TJ;Gutmann L;Barr TL
C-反应蛋白(CRP)是一种炎症生物标志物，可反映血管疾病的进展。相互矛盾的证据表明，CRP可能是预测缺血性卒中预后的生物标志物。大多数研究了C反应蛋白与缺血性卒中预后的关系，将死亡率或随后的血管事件作为主要预后指标。鉴于近一半的中风患者经历了中到重度的功能障碍，使用像CRP这样的生物标志物来预测功能恢复而不是死亡率可能对指导急性中风的治疗具有临床实用价值。本研究的主要目的是系统地、批判性地回顾CRP与缺血性卒中患者长期功能预后的关系，以评估文献的现状。检索PubMed和MEDLINE数据库，寻找评估症状出现后24小时内测得的急性C反应蛋白水平与长期功能结果之间关系的原始研究。搜索得到了1989至2012年间发表的文章。研究包括使用神经成像来确认缺血性中风的诊断，高敏感性的CRP检测，以及评估中风后30天以上预后的功能结局量表。使用评语建议对研究质量进行评估。5项研究符合所有纳入标准。结果表明，基线高敏C反应蛋白升高与不良的长期功能结局显著相关。我们的结果强调有必要进行更多的研究，使用明确的诊断标准来表征急性炎症标志物和长期功能结果之间的关系。有必要进行更多的研究，以前瞻性地检查高敏C反应蛋白措施与长期结果之间的关系。
C-reactive protein (CRP) is an inflammatory biomarker of inflammation and may reflect progression of vascular disease. Conflicting evidence suggests CRP may be a prognostic biomarker of ischemic stroke outcome. Most studies that have examined the relationship between CRP and ischemic stroke outcome have used mortality or subsequent vascular event as the primary outcome measure. Given that nearly half of stroke patients experience moderate to severe functional impairments, using a biomarker like CRP to predict functional recovery rather than mortality may have clinical utility for guiding acute stroke treatments. The primary aim of this study was to systematically and critically review the relationship between CRP and long-term functional outcome in ischemic stroke patients to evaluate the current state of the literature. PubMed and MEDLINE databases were searched for original studies which assessed the relationship between acute CRP levels measured within 24 hours of symptom onset and long-term functional outcome. The search yielded articles published between 1989 and 2012. Included studies used neuroimaging to confirm ischemic stroke diagnosis, high-sensitivity CRP assay, and a functional outcome scale to assess prognosis beyond 30 days after stroke. Study quality was assessed using the REMARK recommendations. Five studies met all inclusion criteria. Results indicate a significant association between elevated baseline high sensitivity CRP and unfavorable long-term functional outcome. Our results emphasize the need for additional research to characterize the relationship between acute inflammatory markers and long-term functional outcome using well-defined diagnostic criteria. Additional studies are warranted to prospectively examine the relationship between high sensitivity CRP measures and long-term outcome.