Röyter Björn, Andréasson Nellie, Forgo Bianka, Källman Jan, Ström Jakob O
Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden.
Department of Geriatrics, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden.
BMC Neurol. 2025 May 30;25(1):233. doi: 10.1186/s12883-025-04244-y.
Body temperature and peripheral blood inflammatory markers are often elevated in acute stroke. Whether the increase in inflammatory markers is caused by the stroke itself or is attributable to a complication, is incompletely understood. This uncertainty may hamper the diagnosis and treatment of infections. We aimed to describe the dynamics of inflammatory parameters in a cohort of stroke patients free from complications.
Acute stroke patients were prospectively included within 48 h of symptom onset and monitored through daily questions of symptoms and clinical examinations to detect complications. Inflammatory parameters in blood and body temperature were measured daily for up to ten days and the 97.5th percentile calculated. Values were compared with paired t-test to measurements at a 90-day follow up.
70 stroke patients were included. 51 of them were considered complication-free and sampled for a total of 282 days. Body temperature, CRP and WBC were all significantly elevated the first days after stroke, compared to 90-days post stroke. Mean body temperature was highest at 24-48h at 37.1°C, mean WBC was highest at 0-24h at 8.1 × 10^9/L, compared to 36.7°C and 6.0 × 10^9/L at the 90-day follow-up (p-values < 0.01). Median CRP peaked at 7.0 mg/L 120-144 h after stroke, compared to 0.9 mg/L at follow-up (p-value < 0.01).
Acute stroke may cause mildly elevated levels of CRP, WBC and body temperature. Except for WBC during the first 24h, higher levels (such as CRP > 50mg/L, WBC > 11 × 10^9/L or body temp > 38°C) are very uncommon (< 2.5%) and are likely to reflect a complication.
急性卒中时体温及外周血炎症标志物常升高。炎症标志物升高是由卒中本身引起还是归因于并发症，目前尚未完全明确。这种不确定性可能会妨碍感染的诊断和治疗。我们旨在描述一组无并发症的卒中患者炎症参数的动态变化。
急性卒中患者在症状发作后48小时内前瞻性纳入研究，并通过每日询问症状和进行临床检查以检测并发症。每天测量血液中的炎症参数和体温，持续长达十天，并计算第97.5百分位数。采用配对t检验将这些值与90天随访时的测量值进行比较。
纳入70例卒中患者。其中51例被认为无并发症，共采样282天。与卒中后90天相比，卒中后最初几天体温、CRP和白细胞均显著升高。平均体温在24 - 48小时最高，为37.1°C，平均白细胞在0 - 24小时最高，为8.1×10^9/L，而90天随访时分别为36.7°C和6.0×10^9/L（p值<0.01）。CRP中位数在卒中后120 - 144小时达到峰值7.0mg/L，随访时为0.9mg/L（p值<0.01）。
急性卒中可能导致CRP、白细胞和体温轻度升高。除了最初24小时内的白细胞外，更高水平（如CRP>50mg/L、白细胞>11××10^9/L或体温>38°C）非常少见（<2.5%），可能反映并发症。
