Prognostic Influence Of C-Reactive Protein Level And White Blood Cell Count In Acute Ischemic Stroke: A Systematic Review

1. Prognostic Influence of C-Reactive Protein Level in Acute Ischemic Stroke: A Systematic ReviewObjective To study the effects of C-reactive protein (CRP) level on the prognosis of patients with acute ischemic stroke through Meta-analysis. Methods The related papers were retrieved in PubMed, MEDLINE(1991-2006),EMBASE (1989-2006), Chinese journals full-text database (1979-2006), Weipu database (1989-2006), Chinese biological medical database (CBM-disk, 1978-2006) and Chinese important conference thesis full-text database (1999-2006) by computer. The methodological quality of these papers was evaluated and the meta-analysis was performed by RevMan 4. 2 software.Results Seven papers including four English and three Chinese papers were adopted and 841 patients met the selection criteria. It's showed that higher CRP level was associated with mortality and morbility of new vascular event. The mortality and morbility of the higher CRP group were 2.71 and 1.81 times more than those of the normal CRP group (OR=3.71 and 2.81, 95%CI: 2.40-5.73 and 1.42- 5.53). The level of CRP was associated with death and relapse of stroke. In the relapse, the average level of CRP was 3.52 mg.L-1 more than that in those didn't relapse. [WMD=3.52, 95%CI (-0.01, 7.05)]. In the dead, the average level of CRP was 8.02 mg.L-1 more than that in the survived and the difference is significant [WMD=8.02, 95%CI (5.68, 10.37), P<0.05]. Conclusions The level of CRP can be used as an index to evaluate the prognosis of patients with acute ischemic stroke.2.Recent Prognostic Influence of White Blood Cell Count in Acute Ischemic Stroke : A Systematic ReviewObjective To study the relationship between white blood cell (WBC) count, cerebral infarct size and recent prognosis of patients with acute ischemic stroke through Meta-analysis.Methods The related papers were retrieved in PubMed, MEDLINE (1991-2006), EMBASE (1989-2006), Chinese journals full-text database (1979-2006), Weipu database (1989-2006), Chinese biological medical database (CBM-disk, 1978-2006) and Chinese important conference thesis full-text database(1999-2006)by computer. The methodological quality of these papers was evaluated and the meta-analysis was performed by RevMan 4. 2 software.Results Ten papers including one English and nine Chinese ones were adopted and 4333 patients met the selection criteria. It's showed that the difference of WBC count between the bigger infarct size group and smaller infarct size group is significant [WMD=4.50, 95%CI (3.90,5.10)]. It's showed that there was a significant difference between acute ischemic stroke group and control group[WMD=3.43,95%CI (3.22,3.64). Up to the deadline , the WBC count of the death group is significantly higher that of the survival group[WMD=4.50, 95%CI (3.87, 5.13). The higher WBC group were 3.47 times more than those of normal WBC group[OR=4.47, 95%CI (2.81, 7.10). But the therapeutic effective power of higher WBC group were only 0.20 times than those of normal WBC[OR=0.20, 95%CI (0.10, 0.38). The differeance are all statistically significant (P<0.05). Conclusions WBC count at the acute stroke is a useful clinical index in evaluating the severity degree and recent prognosis of patients with acute ischemic stroke.