Ibrahimagić Omer C, Sinanović Osman, Cickusić Amra, Smajlović Dzevdet
Klinika za Neurologiju, Univerzitetski Klinicki Centar Tuzla.
Med Arh. 2005;59(2):79-82.
The period following ischemic stroke can be considered as a reaction to a stressful event. Changes in cortisol secretion are one of the indicators of stress reaction. The aim of the study was to determine morning serum levels of cortisol in stroke patients within 48 hours and 15 days of ischemic stroke onset. Study group included 40 patients, 20 of them were females, mean age 65.3 +/- 10.3 years. The patients did not receive any corticosteroid agents or spironolactone, and did not suffer from Cushing's or Addison's syndrome. Ischemic stroke was verified by computed tomography of the brain. The fluorometric method with DELFIA Cortisol immunoassay was used to determine morning serum cortisol levels. Reference values of the measured hormone were 201-681 nmol/l. The mean level of serum cortisol within 48 hours of stroke was 560.9 +/- 318.9 nmol/l, and on day 15 it was 426.2 +/- 159.3 nmol/l, i.e. significantly lower (p < 0.02). On the first measurement, the level of serum cortisol was elevated in 32%, and on the second measurement in only 7.5% patients, which was also significantly lower (p < 0.001). It was concluded that the stress reaction in ischemic stroke patients was more pronounced within the first 48 hours of stroke onset. Judging from the morning cortisol levels, the reaction to stress was considerably less pronounced 15 days after stroke onset.
缺血性中风后的时期可被视为对压力事件的反应。皮质醇分泌的变化是应激反应的指标之一。本研究的目的是确定缺血性中风发作后48小时内及15天时中风患者早晨血清皮质醇水平。研究组包括40名患者，其中20名女性，平均年龄65.3±10.3岁。患者未接受任何皮质类固醇药物或螺内酯治疗，也未患有库欣综合征或艾迪生病。通过脑部计算机断层扫描证实为缺血性中风。采用DELFIA皮质醇免疫分析法的荧光法测定早晨血清皮质醇水平。所测激素的参考值为201 - 681 nmol/l。中风后48小时内血清皮质醇的平均水平为560.9±318.9 nmol/l，第15天时为426.2±159.3 nmol/l，即显著降低（p < 0.02）。首次测量时，32%的患者血清皮质醇水平升高，第二次测量时只有7.5%的患者升高，这也显著降低（p < 0.001）。得出的结论是，缺血性中风患者的应激反应在中风发作后的前48小时内更为明显。从早晨皮质醇水平判断，中风发作15天后对压力的反应明显减弱。
