Relationship Of Bilirubin With Acute Ischemic Stroke And Chinese Ischemic Stroke Subclassification

Objective: To investigate the relationship of the serum bilirubin level with acute ischemic stroke(AIS), and Chinese ischemic stroke subclassification(CISS), stroke severity and short-term outcome of AIS patients.Methods: A total of 616 patients with AIS as well as 664 patients without stroke during the same period matched with gender and age were compared and analyzed with the non-conditional Logistic regression. The AIS patients were divided based on the CISS, and their bilirubin levels were compared. The AIS patients were divided into high bilirubin group and normal bilirubin group, their scores of the National Institute of Health Stroke Scale(NIHSS) as admission and discharge, and neural function improvement rate were compared.Results: 1. The single factor analysis showed that the level of total bilirubin(TBIL), direct bilirubin(DBIL) and indirect bilirubin(IBIL), systolic blood pressure, diastolic blood pressure as well as the he incidence of high blood pressure, diabetes, atrial fibrillation, smoking, drinking were significantly higher in AIS group than that of the control group(P < 0.01).2. Logistic regression analysis showed that smoking(OR=1.473, 95%CI:1.072-2.025, P = 0.017),hypertension(OR=1.519,95%CI:1.178-1.959,P=0.001),diabetes(OR=1.658, 95%CI:1.273-2.160,P<0.001), atrial fibrillation(OR=2.007, 95%CI:1.137-3.543, P=0.016), TBIL(OR=1.026,95%CI:1.012-1.041, P < 0.001) are independent risk factors of AIS.3. Serum bilirubin level in CISS subclassification: There was no significant difference of the levels of TBIL, DBIL and IBIL among the patients of CISS(P>0.05).4. Comparison of NIHSS scores in different bilirubin levels:The NIHSS score was higher in the high bilirubin group than in the normal bilirubin group as admission(P<0.05), but it was not significant as discharge(P>0.05), nor the rate of neural function improvement(P>0.05).Conclusions: 1. TBIL, DBIL, IBIL, systolic blood pressure, diastolic blood pressure and hypertension, diabetes mellitus, atrial fibrillation, smoking and drinking were related to the incidence of AIS.2. Smoking, high blood pressure, diabetes, atrial fibrillation, and TBIL are independent risk factors of AIS.3. The bilirubin was not various with the CISS.4.The level of TBIL was positively correlated with the severity of AIS as admission, and might be less involved in the discharge and short-term outcome of AIS.