The Correlation Study Between The Level Of High-sensitivity C-reactive Proteion In Acute Phase Of Ischemic Stroke And Early Neurologic Deterioration

ObejectsTo study the correlation of the level of high-sensitivity C-reactive proteion(Hs-CRP) in the acute phase of ischemic stroke and early neurologic deterioration (END) in ischemic stroke.MethordsPatients with acute ischemic stroke consecutively hospitalized in the Department of Neurology of Anhui Provincial Hospital affiliated to Medical University Of Anhui were prospectively collected from August 2014 to September 2015. To collect the clinical data of patients, including age, gender, history of hypertension, history of diabetes, history of myocardial infarction, history of cerebral infarction, atrial fibrillation, smoking history, admission blood glucose, total cholesterol, triglyceride, admission leukocyte count, pulmonary infection and urinary tract infection complicated within 72 hours of acute stage. The study included 101 patients through the inclusion and exclusion criteria. Serum Hs-CRP of all patients were measured in 24 hours, the onset of 48 hours, the onset of 72 hours by latex enhanced immune turbidity method. High sensitivity C-reactive protein sustained growth was defined as:the content of high sensitivity C-reactive protein in disease incidence 48 hours,72 hours was more than 20% and above the content of high sensitivity C-reactive protein 24 hours after admission. Early neurologic deterioration (END) Definition:ischemic stroke onset 72 hours National Institutes of Health Stroke Scale (NIHSS) score than the admission NIHSS score increased by 2 points or 2 points or more. According to the definition of high sensitivity C- reactive protein sustained growth,the patients were divided into the group of Hs-CRP sustained growth (n=35) and the group of non Hs-CRP sustained growth (n=66). The possible related factors of Hs-CRP sustained growth and the possible risk factors for early neurologic deterioration were selected by multivariate Logistic regression analysis.ResultsThere were significant differences between the two groups within 24 hours of admission, the incidence of 48 hours and 72 hours of onset hypersensitivity C-reactive protein (P<0.001). Hypersensitive C-reactive protein sustained growt h group 35 patients,26 (74.29%) patients with early neurological deterioration. Hypersensitive C-reactive protein unsustainable growth group 66 patients,11 (16.67%) patients with early neurological deterioration.The incidence of early neurological deterioration in the group of Hs-CRP sustained growth was signifi cantly higher than that in the group of non Hs-CRP sustained growth(x2=32.71 0, P<0.001). The factors that they included blood glucose(OR:1.744,95%CI:1.01 8-2.988, P=0.043), white blood cell count(OR:2.067,95%CI:1.361-3.140,P=0.00 1), triglyceride level(OR:4.871,95%CI:1.695-14.001,P=0.003),NIHSS scores at ad mission(OR:1.221,95%CI:1.028-1.499,P=0.023),Hs-CRP within 24 hours(OR:1.47 1,95%CI:1.035-2.091,P=0.031) were associated with sustained growth of Hs-C RP and the factors that they included Hs-CRP sustained growth(OR:4.368,95% CI:1.214-15.714,P=0.024), admission NIHSS scores(OR:1.395,95%CI:1.144-1.70 2, P=0.001), Diabetes mellitus(OR:5.202,95%CI:1.458-18.560, P=0.011) and pulmonary infection(OR:4.659,95%CI:1.168-18.580, P=0.029) were regarded as independent risk factors by Multivariate Logistic regression analysis.ConclusionsHypersensitivity C- reactive protein sustained growth in acute phase of ischemic stroke implied enhanced acute phase inflammatory response. Enhanced acute phase systemic inflammation may be the pathophysiology of ischemic stroke early neurological deterioration occurred.The sustained growth of Hs-CRP in the acute phase of ischemic stroke may be an independent risk factor of progressive stroke.