目的 探讨血清铁蛋白及超敏C反应蛋白联合检测对急性脑出血患者的临床意义。方法 2012年1月—2015年12月,自发性脑出血的患者77例,男42例,女35例;年龄45～82 a,平均年龄(67.19±10.17)a。根据Rankin 评分将患者分成两组,A组,MRS≤2分,预后良好; B组,MRS＞2分,预后差;另选取同期健康体检者35例作为健康对照组,即C组。分别于入院时、发病后第3天、7天、14天时,采静脉血化验血常规、Hs-CRP及SF;于入院时和发病后第3天时,进行头颅CT检查。采用美国国立卫生院神经功能缺损评分(National Institutes of Health Stroke Scale,NIHSS) 分别于入院及随访12个月时,对两组患者神经功能损伤及恢复情况进行评估。结果 77例脑出血患者在发病12个月随访时, 53例患者MRS≤2分,预后良好;24例患者MRS＞2分,预后较差。于入院时、发病后第3天、7天、14天,脑出血患者的Hs-CRP及SF水平均显著高于健康体检人员,差异具有统计学意义(P<0.05);在各时间点脑出血患者中的预后较差组Hs-CRP及SF水平均不同程度高于预后良好组;但在入院发病后第3天则显著高于预后良好组,差异具有统计学意义(P<0.05),同时,脑出血患者中的预后较差组脑水肿量及水肿系数均显著高于预后良好组,差异具有统计学意义(P<0.05)。影响脑出血预后的独立危险因素包括NIHSS评分(P=0.012),Hs-CRP(P=0.027)和SF水平(P=0.041)。结论 Hs-CRP及SF水平在一定程度上可作为脑出血预后的重要评估指标。

Objective To investigate the clinical significance of combined detection of serum ferritin and high sensitive C reactive protein in patients with acute cerebral hemorrhage. Methods From January 2012 to December 2013, 77 cases with cerebral hemorrhage male 42, female 35; aged 45 to 82 year old, average age (67.19±10.17)years old. According to MRS(Modified Rankin Scale) score criteria, patients were divided into good prognosis group(group A) with MRS ≤2, and poor prognosis group (group B)with MRS ＞2. Another 35 cases of healthy physical examination were selected as the healthy control group(group C). RT(Routine blood test), Serum Ferritin(SF)and Hs-CRP were tested at the time of admission, the third, the seventh and the fourteenth day from onset of the disease respectively. Head CT were done at the time of admission, the third day from onset of the disease respectively. Neurological assessment were scored according to the NIHSS criteria(National Institutes of Health Stroke Scale) for the patients in the two groups at the time of admission and 12 months of follow up. Results 77 cases of cerebral hemorrhage were followed up for 12 months, 53 cases with MRS ≤2, the prognosis was good; And 24 cases with MRS >2, the prognosis was poor. The levels of Hs-CRP and SF were all higher in patients with cerebral hemorrhage than that in healthy control group (P<0.05) at the time of admission, the third day,seventh and fourteen day from onset of the disease respectively. The levels of Hs-CRP and SF were higher in group B than that in control group at the time of admission, the third day, the seventh day and the fourteenth day from onset of the disease respectively, but only at the time of admission, three days from onset of the disease, the difference was statistically significant (P<0.05). At the same time, the brain edema and edema index in the group B were higher than those in group A. The independent risk factors influencing the prognosis of cerebral hemorrhage were NIHSS score (P=0.012), Hs-CRP(P=0.027) and SF(P=0.041). Conclusion Hs-CRP and SF may be important indicators of the prognosis for cerebral hemorrhage in a certain degree.

目的 探讨绝经期后女性血清铁蛋白水平与代谢综合征之间的关系。方法 收集218例确诊为MS的绝经期后女性患者为试验组,对照组为经我院检查健康绝经期后的女性300例,分别测FBG、TC、TG、LDL-C、HDL-C、HbA1C、INS、SF;计算体重指数(BMI)以及测量腰围;测血压;用HOMA稳态模型来评价胰岛素抵抗指数(HOMA-IR)。结果 MS组较非MS组的铁蛋白(SF)值高(P<0.01),SF四分位各组之间比较,FBG、TG、HDL-C,BMI,腰围,收缩压、舒张压有差异(P<0.05或P<0.01),四组间年龄、TC、LDL-C无差异。与SF呈正相关的参数有腰围(P<0.01),舒张压(P<0.01),空腹血糖(P<0.01),胰岛素抵抗指数(P<0.01),负相关的参数为HDL-C(P<0.01)。结论 绝经期后女性的SF水平与MS呈显著相关,其中腰围、舒张压、空腹血糖、HDL-C、胰岛素抵抗指数与血清铁蛋白之间存在较大关联性。

Objective To study the relationship of serum ferritin level with metabolic syndrome in postmenopausal women. Methods 218 postmenopausal women with metabolic syndrome and 300 healthy postmenopausal women were included in this investigation, to detect FBG, TC, TG, LDL- C, HDL-C, HbA1C, INS, SF, calculated body mass index (BMI) and to measure waist circumference, blood pressure; Using HOMA steady-state model to evaluate indexes of insulin resistance (HOMA IR). Results Serum ferritin level was significantly higher in MS group than in the non-MS group(P<0.01). Serum ferritin quarterback was compared between each group, there were differences in FBG, TG, HDL-C,BMI, waist circumference,SBP, DBP(P<0.05 or P<0.01). There were no differences in age, TC, LDL-C. Serum ferritin level was significantly positive correlated with waist circumference (P<0.01), DBP(P<0.01), FBG(P<0.01), insulin resistance index (P<0.01), and negative correlation with HDL-C(P<0.01). Conclusion Serum ferritin level is significantly associated with metabolic syndrome in postmenopausal women. Waist circumference, DBP, FBG, HDL -C, insulin resistance index are closely associated with the serum ferritin.