Khanevski A N, Naess H, Thomassen L, Waje-Andreassen U, Nacu A, Kvistad C E
Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Centre of Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.
Acta Neurol Scand. 2017 Nov;136(5):414-418. doi: 10.1111/ane.12743. Epub 2017 Mar 1.
Some studies suggest that high body temperature within the first few hours of ischemic stroke onset is associated with improved outcome. We hypothesized an association between high body temperature on admission and detectable improvement within 6-9 hours of stroke onset.
Consecutive ischemic stroke patients with NIHSS scores obtained within 3 hours and in the interval 6-9 hours after stroke onset were included. Body temperature was measured on admission.
A total of 315 patients with ischemic stroke were included. Median NIHSS score on admission was 6. Linear regression showed that NIHSS score 6-9 hours after stroke onset was inversely associated with body temperature on admission after adjusting for confounders including NIHSS score <3 hours after stroke onset (P<.001). The same result was found in patients with proximal middle cerebral occlusion on admission.
We found an inverse association between admission body temperature and neurological improvement within few hours after admission. This finding may be limited to patients with documented proximal middle cerebral artery occlusion on admission and suggests a beneficial effect of higher body temperature on clot lysis within the first three hours.
一些研究表明，缺血性卒中发病后最初几小时内的高热与较好的预后相关。我们推测入院时的高热与卒中发病后6 - 9小时内可检测到的病情改善之间存在关联。
纳入发病后3小时内及发病后6 - 9小时期间获得美国国立卫生研究院卒中量表（NIHSS）评分的连续缺血性卒中患者。入院时测量体温。
共纳入315例缺血性卒中患者。入院时NIHSS评分中位数为6分。线性回归显示，在调整包括卒中发病后<3小时的NIHSS评分等混杂因素后，卒中发病后6 - 9小时的NIHSS评分与入院时体温呈负相关（P<0.001）。入院时大脑中动脉近端闭塞的患者也得到相同结果。
我们发现入院时体温与入院后数小时内神经功能改善之间存在负相关。这一发现可能仅限于入院时有大脑中动脉近端闭塞记录的患者，并提示较高体温在发病后最初三小时内对血栓溶解有有益作用。
