Wartenberg Katja E, Stoll Anett, Funk Andreas, Meyer Andreas, Schmidt J Michael, Berrouschot Joerg
Department of Neurology, Martin Luther University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120 Halle (Saale), Germany.
Stroke Res Treat. 2011;2011:830614. doi: 10.4061/2011/830614. Epub 2011 Jun 12.
Background. The activation of inflammatory cascades triggered by ischemic stroke may play a key role in the development of infections. Methods. Patients admitted with ischemic stroke within 24 hours were prospectively enrolled. Biomarkers of infection were measured on days 1, 3, and 5. The patients were continuously monitored for predefined infections. Results. Patients with infection were older (OR 1.06 per year, 95% CI 1.01-1.11) and had a higher National Institute of Health Stroke Scale Score (NIHSS, OR 1.21, 95% CI 1.10-1.34), localization in the insula, and higher stroke volumes on diffusion-weighted imaging. The maximum temperature on days 1 and 3, leukocytes, interleukin-6, lipopolysaccharide-binding protein on days 1, 3, and 5, C-reactive protein on days 3 and 5, and procalcitonin on day 5 were higher and HLA-DR-expression on monocytes on days 1, 3, and 5 lower in patients with infection. Age and NIHSS predicted the development of infections. Infection was an independent predictor of poor functional outcome. Conclusions. Severe stroke and increasing age were shown to be early predictors for infections after stroke.
背景。缺血性卒中引发的炎症级联反应激活可能在感染的发生发展中起关键作用。方法。前瞻性纳入发病24小时内入院的缺血性卒中患者。在第1、3和5天测量感染生物标志物。对患者持续监测是否发生预设感染。结果。感染患者年龄更大（每年OR 1.06，95%CI 1.01 - 1.11），美国国立卫生研究院卒中量表评分（NIHSS）更高（OR 1.21，95%CI 1.10 - 1.34），梗死灶位于脑岛，且弥散加权成像显示的梗死体积更大。感染患者在第1天和第3天的最高体温、白细胞、第1、3和5天的白细胞介素 - 6、脂多糖结合蛋白、第3和5天的C反应蛋白以及第5天的降钙素原更高，而第1、3和5天单核细胞上的HLA - DR表达更低。年龄和NIHSS可预测感染的发生。感染是功能预后不良的独立预测因素。结论。严重卒中及年龄增长被证明是卒中后感染的早期预测因素。
