Kleu Jnmc, Belagavi.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Stroke is defined as 'the rapid development of clinical signs and symptoms of a focal neurological deficit lasting for more than 24 hours or leading to death with no apparent cause other than vascular origin'. Serum Calcium has an important role in signal transduction pathways and may influence the severity of stroke during initial period. Serum Albumin as an acute phase reactant; with its neuro-protective action prejudices the recovery. Whereas Serum Uric acid acts as a marker of tissue infarction; indicating poor prognosis of ischemic stroke. This study was conducted using these three lab parameters to assess the severity & short term prognosis of acute ischemic stroke.
This is a one year Observational Cross sectional study conducted on 65 patients aged above 18 years, presenting with Acute Ischemic Stroke within 24 hours of onset. Patients with Haemorrhagic stroke, chronic liver & renal diseases were excluded. National Institute of Health Stroke Scale (NIHSS) severity score was calculated at admission, with estimation of Serum Calcium, Albumin & Uric acid. Short term prognosis is assessed based on functional improvement using Modified Rankin Scale (MRS) grading done at the end of 1st week.
Stroke was common in the age group of 5th to 8th decade. Male & female patients were 45 (69.23%) and 20 (30.77%) respectively. Male preponderance was seen with the ratio of 2.25:1. Hypertension was seen in 17 patients (26.15%), overlapping comorbidities were observed in 19 patients (29.23%), Diabetes in 06 patients (9.23%), Coronary artery disease in 05 (7.69%). Hypertension and Diabetes did not show any significant correlation on outcome. Lab parameters like serum calcium, serum albumin and serum uric acid when compared with NIHSS scoring; the positive correlation was seen only with low serum calcium levels and the other two parameters did not show any positive correlation. Similarly comparing all the three parameters with Modified Rankin Scale did not show any positive correlation.
We observed a significant correlation only between serum calcium levels and NIHSS severity. The three lab parameters did not yield any association with MRS grades. There is a need to conduct a large scale prospective study and to consider various other patient related factors to eliminate bias and to establish association between those three lab parameters with acute ischemic stroke.
中风定义为“局灶性神经功能缺损的快速发展，持续超过 24 小时或导致死亡，除血管源性外无明显原因”。血清钙在信号转导途径中具有重要作用，可能会影响中风初期的严重程度。血清白蛋白作为急性期反应物，具有神经保护作用，可预测恢复情况。而血清尿酸则作为组织梗死的标志物，表明缺血性中风的预后不良。本研究使用这三个实验室参数来评估急性缺血性中风的严重程度和短期预后。
这是一项为期一年的观察性横断面研究，纳入了 65 名年龄在 18 岁以上、发病 24 小时内出现急性缺血性中风的患者。排除出血性中风、慢性肝肾功能疾病患者。入院时计算国立卫生研究院中风量表（NIHSS）严重程度评分，并测定血清钙、白蛋白和尿酸。短期预后根据第 1 周末改良 Rankin 量表（MRS）分级的功能改善情况进行评估。
中风在 5 至 8 个十年龄组中较为常见。男性和女性患者分别为 45 例（69.23%）和 20 例（30.77%）。男性居多，男女比例为 2.25:1。高血压见于 17 例（26.15%），重叠合并症见于 19 例（29.23%），糖尿病见于 6 例（9.23%），冠心病见于 5 例（7.69%）。高血压和糖尿病与预后无显著相关性。与 NIHSS 评分相比，血清钙、血清白蛋白和血清尿酸等实验室参数仅与低血清钙水平呈正相关，其他两个参数无明显正相关。同样，将这三个参数与 MRS 分级进行比较，也没有显示出任何正相关。
我们仅观察到血清钙水平与 NIHSS 严重程度之间存在显著相关性。这三个实验室参数与 MRS 分级均无相关性。需要进行大规模前瞻性研究，并考虑其他各种与患者相关的因素，以消除偏倚，并确定这三个实验室参数与急性缺血性中风之间的关系。
