Systemic inflammatory response depends on initial stroke severity but is attenuated by successful thrombolysis
Systemic inflammatory response depends on initial stroke severity but is attenuated by successful thrombolysis
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DOI：
10.1161/01.str.0000137607.61697.77
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发表时间：
2004-09-01
期刊：
影响因子：
8.3
通讯作者：
Haberl, RL
中科院分区：
文献类型：
--
作者：
Audebert, HJ;Rott, MM;Haberl, RL
背景和目的-确定中风发作后第一天内的体温、C-反应蛋白（CRP）和白色血细胞（WBC）计数是否与梗死面积和中风严重程度相关，并检查成功的血栓溶解是否减少中风后炎症。根据以下标准选择346例（43例溶栓患者）：事件发生后≤ 24 h入院，无卒中前和卒中后感染性疾病，无脑内出血或脑干卒中，数据可用。每天测定体温、3天内的WBC和5天内的CRP。通过计算机断层扫描或MRI扫描的面积测量法测量病变体积。成功的血栓溶解定义为24小时内美国国立卫生研究院中风量表改善大于或等于4分。结果-炎症参数的增加与病变体积和中风严重程度显着相关。第2、3天的体温、第1 ~ 5天的CRP、第1 ~ 3天的白细胞数均显著高于对照组（P <0.001）。溶栓成功的患者在第3天体温下降，第2、3天WBC下降，第3 ~ 5天CRP下降（P < 0.05）。成功的血栓溶解与显著减弱的炎症反应有关。
Background and Purpose - To determine whether body temperature, c-reactive protein (CRP), and white blood cell (WBC) count within the first days after stroke onset correlate with infarct size and stroke severity, and to examine whether successful thrombolysis reduces poststroke inflammation.Methods - Out of 1500 consecutive acute ischemic stroke patients, 346 cases ( 43 patients with thrombolysis) were selected according to the following criteria: admission to hospital less than or equal to 24 hours after event, absence of prestroke and poststroke infectious disease, no intracerebral hemorrhage or brain stem stroke, and data availability. Body temperature, WBC within 3 days, and CRP within 5 days of event were determined daily. Lesion volume was measured by planimetry on computed tomography or MRI scans. Successful thrombolysis was defined as improvement on the National Institutes of Health Stroke Scale of greater than or equal to 4 points within 24 hours.Results - Increase of inflammatory parameters correlated significantly with lesion volume and stroke severity. This was shown for body temperature on days 2 and 3 ( P < 0.001), CRP on days 1 to 5 ( P < 0.05), and WBC on days 1 to 3 ( P < 0.01). Patients with successful thrombolysis had reduced body temperature on day 3, WBC on days 2 and 3, and CRP on days 3 to 5 ( P < 0.05).Conclusions - Patients with a larger stroke volume and more severe stroke deficits have higher body temperature, CRP, and WBC count in the acute phase after stroke. Successful thrombolysis is related to a significantly attenuated inflammatory response.