The Relationship Between The Level Of Hypersensitive C-reactive Protein In Admission And The Outcome At Discharge In Patients With Acute Ischemic Stroke

Objective：As the first cause leading to the morbidity of human in theworld，stroke has become the most secondary to human death. Ischemic strokeaccounts for88%in all kinds of stroke. The burden of the stroke for thesociety has been a very severe public healthy problem. Nowadays manystudies suggest that the inflammation play an important role in the mechanism.In this study, we want to discuss the role of cytokine in the outcome atdischarge in patients with primary-acute ischemic stroke by testing the level ofhypersensitive C-reactive protein (hs-CRP) in admission, analyzing theassociated factors, providing the scientific evidence for prevention andtreatment for acute ischemic stroke.Methods: According to the Chinese Acute Ischemic Stroke Diagnosisand Treatment Guideline (2010) ischemic stroke diagnosis standard, based onthe Suzhou university health science public health colleage issue “Associationof infection Agent and Acute inflammation Makers with Prognosis of AcuteIschemic Stroke”(National Science Foundation81172760), in a perspectivecohort study from August2012to June2013,120patients with primary-acuteischemic stroke was included and collected with clinical data, those cases thatis resulted by brain tumor、trauma and so on was excluded. We do the clinicalneurologic impairment degree score when in admission by the NationalInstitutes of Health Stroke Scale (NIHSS), and collected possible factors mayinfluenced the outcome. The related biochemical tests was admitted in24hours, outcome was measured with the Modified Rankin scale (MRs) whensubjects were in admission and at discharged. The good outcome was definedas0≤MRs≤2, the poor outcome is defined as MRs≥3. We use the17.0SPSS and the SAS software package to make the regression analysis for all the hs-CRP and Systolic Blood Pressure, Diastolic Blood Pressure, heart rate, totalcholesterol, triglyceride, glucose and NIHSS. We discuss the relationshipbetween the level of hypersensitive C-reactive protein in admission and theoutcome at discharge in patients with acute ischemic stroke, using the logisticmultiple factor analysis. P <0.05is considered statistically significant.Result:1. There are46patients with the MRs≥3in admission, and therate is38.4%, the poor-outcome patients at discharge is30%, descending8.4%.P=0.0042(P<0.05)，has statistically significant.2. The level of the hs-CRP inthe poor-outcome is higher than the good-outcome’s. P<0.05, has statisticallysignificant.3. hs-CRP is divided into three groups according to the trichotomy.we find the statistically significant in the in admission days、the NIHSS、Diastolic Blood Pressure and hs-CRP level between the good outcome andpoor outcome.4. After adjusting for multiple factors, we find the risk of thepoor outcome with hs-CRP level in the second trichotomy is higher than thatin the first level. the OR and95%CI is1.321(0.423~4.125), and in the thirdone is3.758(1.257~11.231), which has statistically significance. With theincrease of the hs-CRP level, the risk of the poor outcome at discharge is onincrease. They have the tendency relationship.Conclusion:1. The level of the hs-CRP in the poor-outcome is higherthan the good-outcome’s.2. The influential factors related to the rate of theshort-term poor outcome in the first-acute ischemic stroke include inadmission days、the NIHSS、Diastolic Blood Pressure and hs-CRP level.3.The risk of the poor outcome in high level of the hs-CRP is3.758times thanthe low level. The rise of the hs-CRP could increase the risk of poor outcomein short-term in ischemic stroke patients, there was dose-response relationship,and hs-CRP was an independent risk factor.