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缺血性脑卒中急性期反应物和细胞因子:它们与短期死亡率有任何关系吗?

Acute-phase reactants and cytokines in ischemic stroke: do they have any relationship with short-term mortality?

机构信息

Emergency Medicine Service, Elazıg Education and Research Hospital, Elazig, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2013 Oct;17(20):2773-7.

PMID:24174359
Abstract

BACKGROUND

Many unknown risk factors play a role in the etiopathogenesis of stroke. The appearance of inflammatory cells within the damaged tissue after cerebral ischemia suggests that an inflammatory response may play a role in stroke pathogenesis. In our study, we examined whether an association exists between the acute-phase reactants and the levels of cytokines, the volume and diameter of the stroke, and short-term mortality in patients who were diagnosed as acute ischemic a stroke after admission to the Emergency Department.

PATIENTS AND METHODS

A total of 50 consecutive patients who applied to the Emergency Service with acute ischemic stroke were enrolled in the study. Their stroke volume were calculated and serum samples were obtained as soon as they arrived into the Emergency Service. The patients were evaluated according to the Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS).

RESULTS

There was no significant correlations between stroke volume and levels of cytokine and acute-phase reactants in dead patient group or in living patient group. A correlation and statistical significance was found between stroke volume and hospital stay time in living patient group. In addition, GCS and NIHSS scores were correlated with stroke volume and was found a significant statistically.

CONCLUSIONS

Scales such as GKS and NIHHS, which evaluate the functional state of patients, are the best indicators for defining prognosis in our daily practices. In addition, we found a positive correlation between levels of CRP (C reactive protein) and prognosis. However, we did not observe a statistically significant correlation between prognosis and other acute-phase reactants such as TNF-alpha, IL-6, IL-8, IL-10, fibrinogen, and leukocytes.

摘要

背景

许多未知的风险因素在中风的病因学中起作用。脑缺血后损伤组织内炎症细胞的出现表明炎症反应可能在中风发病机制中起作用。在我们的研究中,我们检查了在被诊断为急性缺血性中风后入住急诊部的患者中,急性期反应物与细胞因子水平、中风体积和直径以及短期死亡率之间是否存在关联。

患者和方法

共纳入 50 例连续就诊于急诊的急性缺血性中风患者。他们一到急诊室就抽取血清样本并计算中风体积。根据格拉斯哥昏迷量表(GCS)和美国国立卫生研究院中风量表(NIHSS)对患者进行评估。

结果

在死亡组和存活组中,中风体积与细胞因子和急性期反应物水平之间均无显著相关性。在存活组中,中风体积与住院时间之间存在相关性和统计学意义。此外,GCS 和 NIHSS 评分与中风体积相关,且具有统计学意义。

结论

在我们的日常实践中,评估患者功能状态的量表如 GKS 和 NIHHS 是定义预后的最佳指标。此外,我们发现 CRP(C 反应蛋白)水平与预后呈正相关。然而,我们没有观察到预后与其他急性期反应物(如 TNF-α、IL-6、IL-8、IL-10、纤维蛋白原和白细胞)之间存在统计学显著相关性。

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