Department of Neurology, Medical School of Ataturk University, Erzurum, Turkey.
Int J Neurosci. 2009;119(12):2206-18. doi: 10.3109/00207450903222733.
Our aim was to evaluate the relationship between lesion volume, serum level of biochemical markers, and clinical situation in ischemic and hemorrhagic stroke.
MRI was obtained on 33 ischemic and 28 hemorrhagic strokes. The Cavalieri method was used to measure the volume. To evaluate neurological situation of the patients, we used the National Institutes of Health Stroke Scale (NIHSS) and Rankin Disability Scores at the first, third, seventh, and thirtieth days. We measured the level of leptin, high sensitivity C-reactive protein (hs-CRP), insulin, cortisol, fibrinogen, protein C, protein S, von Willebrand factor, D-dimer, Antitrombin III, and Factor VIII (F VIII) at the same time intervals.
In ischemic events, cortisol level at third and seventh days, and fibrinogen level at the first day were correlated with lesion volumes (r = 0.5, p = .02; r = 0.4, p = .02; r = 0.5, p = .005, respectively). In hemorrhagic events, only fibrinogen level was correlated with lesion volumes at third day (r = 0.6, p = .04). No significant differences were found among all these biochemical parameters, neurological situation (p > .05), and lesion volumes at all times.
In the prediction of stroke prognosis, lesion volume and all of the evaluated biochemical parameters are not deterministic factors.
本研究旨在评估缺血性和出血性卒中患者的病灶体积、生化标志物血清水平与临床状况之间的关系。
对 33 例缺血性卒中和 28 例出血性卒中患者进行 MRI 检查。采用 Cavalieri 方法测量病灶体积。使用国立卫生研究院卒中量表（NIHSS）和Rankin 残疾评分评估患者的神经状况，分别于第 1、3、7 和 30 天进行评估。同时在相同时间间隔测量瘦素、高敏 C 反应蛋白（hs-CRP）、胰岛素、皮质醇、纤维蛋白原、蛋白 C、蛋白 S、血管性血友病因子（vWF）、D-二聚体、抗凝血酶 III 和因子 VIII（F VIII）的水平。
在缺血性事件中，皮质醇水平在第 3 天和第 7 天，以及纤维蛋白原水平在第 1 天与病灶体积呈正相关（r = 0.5，p =.02；r = 0.4，p =.02；r = 0.5，p =.005）。在出血性事件中，仅纤维蛋白原水平与第 3 天的病灶体积呈正相关（r = 0.6，p =.04）。所有这些生化参数、神经状况（p >.05）和所有时间的病灶体积之间均无显著差异。
在预测卒中预后时，病灶体积和所有评估的生化参数都不是确定性因素。
