Department of General Medicine, All India Institute of Medical Sciences, Patna, India.
Department of General Medicine, All India Institute of Medical Sciences, Patna, India
BMJ Open. 2024 Nov 28;14(11):e085078. doi: 10.1136/bmjopen-2024-085078.
This study was conducted with the aim of assessing the correlation between highly sensitive C reactive protein (hsCRP) levels and indicators of disability and functional impairment in individuals presenting with acute ischaemic stroke (AIS).
Cross-sectional study.
Department of General Medicine at the All India Institute of Medical Sciences, Patna, Eastern India from August 2022 to August 2023.
The study population comprised a total of 125 patients aged 18 years or more, presenting within 48 hours of symptom onset or time last known well and having confirmed ischaemic stroke through CT or MRI of the brain. Individuals with a history of prior stroke, other neurological disorders, active infections, known coronary artery disease, chronic kidney disease, chronic liver disease and abnormal blood cell counts were excluded.
Modified Rankin scale (mRS) and Barthel Index (BI) scores on day 2 and day 5 were the primary outcome measures.
The hsCRP levels on day 2 and day 5 were significantly positively correlated with the National Institutes of Health Stroke Scale scores with Spearman's rho 0.303 (p=0.001) and 0.386 (p<0.001), respectively. The hsCRP on day 2 exhibited a significant association with mRS scores (p=0.04), indicating disability, but this significance was not sustained on day 5 (p=0.125). A negative correlation was observed between hsCRP and BI scores on both day 2 (Spearman's rho=-0.265, p=0.003) and day 5 (Spearman's rho=-0.297, p=0.002). While the hsCRP levels on day 2 did not differ significantly between fatal and non-fatal cases (p=0.110), the hsCRP levels on day 5 were significantly higher in fatal cases (p<0.001).
This study underscores the potential utility of hsCRP as a prognostic indicator in patients with AIS. Elevated hsCRP levels correlated with increased stroke severity and functional disability. Regular assessments of hsCRP in the early phase of AIS could contribute to predicting prognosis and guiding optimal patient management.
本研究旨在评估高敏 C 反应蛋白（hsCRP）水平与急性缺血性脑卒中（AIS）患者残疾和功能障碍指标之间的相关性。
横断面研究。
印度东部巴特那全印度医学科学研究所普通医学系，2022 年 8 月至 2023 年 8 月。
研究人群包括总共 125 名年龄在 18 岁及以上的患者，他们在症状发作后 48 小时内或最后一次已知健康时就诊，且通过脑部 CT 或 MRI 确诊为缺血性脑卒中。排除既往有脑卒中、其他神经疾病、活动性感染、已知冠心病、慢性肾脏病、慢性肝病和异常血细胞计数的患者。
第 2 天和第 5 天的改良 Rankin 量表（mRS）和巴氏指数（BI）评分是主要结局测量指标。
第 2 天和第 5 天的 hsCRP 水平与国立卫生研究院脑卒中量表评分呈显著正相关，Spearman rho 值分别为 0.303（p=0.001）和 0.386（p<0.001）。第 2 天的 hsCRP 与 mRS 评分显著相关（p=0.04），表明存在残疾，但第 5 天的相关性不显著（p=0.125）。hsCRP 与第 2 天（Spearman rho=-0.265，p=0.003）和第 5 天（Spearman rho=-0.297，p=0.002）的 BI 评分呈负相关。虽然第 2 天的 hsCRP 水平在致命和非致命病例之间无显著差异（p=0.110），但第 5 天的 hsCRP 水平在致命病例中显著更高（p<0.001）。
本研究强调了 hsCRP 作为 AIS 患者预后指标的潜在效用。hsCRP 水平升高与卒中严重程度和功能障碍增加相关。在 AIS 的早期阶段定期评估 hsCRP 可能有助于预测预后并指导最佳患者管理。
