The Predictive Value Of S100β And Hs-CRP For The Clinical Outcome Of Patients With Cerebral Infarction

Objective The aims of this dissertation is to study the expression of serum S100β protein and hs-CRP in patients with acute cerebral infarction and to understand the predictive value of S100β and hs-CRP on the clinical outcome of patients with cerebral infarction at 3 months.so as to conduct stratified management of patients with acute cerebral infarction and improve the efficiency of medical resource allocation.Methods A total of 194 patients in the Department of Neurology of the Second Hospital of Longyan Fujian Province were selected from October 2019 to May2020.Acccording to the diagnostic criteria of cerebral infarction of “2018 Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke”,the study subjects were divided into two groups:(1)Cerebral Infarction Group:100 patients with cerebral infarction were selected as cerebral infarction group.The prognosis of patients was evaluated by modified Ranking scale at 3 months after discharge:66patients had good prognosis(MRS ≤2)and 34 patients had poor prognosis(MRS≥3).The volume of infarct lesion was calculated according to Pullicino formula,and then the patients were divided into three groups: 46 cases in small infarction group(V<5cm~3,46%),32 cases in middle infarction group(5≤V<10cm~3,32%),and 22 cases in large infarction group(V≥10cm~3,22%).According to the degree of neurological impairment(NIHSS score),50 cases were mild(0～4,50%),25 cases were moderate(5～15,25%)and 25 cases were severe(>15,25%).(2)Control Group:94 patients with non-cerebral infarction in our hospital in the same period were selected as control group.At the same time,general data of all subjects were collected,including gender,age,hypertension,diabetes,smoking history,drinking history,atherosclerotic plaque,hyperlipemia,homocysteine,and so on.The degree of neurological impairment at admission in acute cerebral infarction group was evaluated by National Institutes of Health Stroke Scale.The patients with acute cerebral infarction were followed up by face to face or by telephone at 3 months after discharge and the recovery of neurological function was evaluated by modified Ranking scale.The level of serum S100β protein in all patients were measured by double antibody method ELISA with Multiskan Ascent enzyme labeling instrument(Rebauer company,Finland)and the level of serum hs-CRP in all patients were measured by latex enhanced scattering turbidimetry with automatic specific protein analyzer(BN Ⅱ,Deling company,USA).The SPSS21 was used to analyze and compare the general data of all subjects,serum S100β protein level and hs-CRP level between the two groups,which shows statistical differences with P<0.05.Results 1.According to the comparison of general clinical data,there was no significant difference in gender,age,hypertension,diabetes,smoking history,drinking history,atherosclerotic plaque,hyperlipemia and homocysteine between the two groups(p>0.05).2.According to the comparison of serum S100β protein and hs-CRP levels between the two groups,the levels of serum S100β and hs-CRP were(0.282±0.325)ng/ml and(8.39±3.62)mg/L in acute cerebral infarction group,(0.103±0.089)ng/ml and(2.75±1.11)mg/L in control group.There were statistically significant differences(P<0.05).3.According to the comparison of general clinical data of patients with different prognosis at 3 months after discharge,there was no significant difference in gender,age,hypertension,diabetes,smoking history,drinking history,atherosclerotic plaque and homocysteine between the two groups(p>0.05).But there was statistical difference in hyperlipidemia(P<0.05).4.According to the comparison of serum S100β protein and hs-CRP levels among patients with different prognosis at 3 months after discharge,the levels of serum S100β and hs-CRP were(0.457±0.487)ng/ml and(11.382±1.93)mg/L in poor prognosis group,(0.197±0.096)ng/ml and(8.076±3.25)mg/L in good prognosis group.There were statistically significant differences(P<0.05).5.Bivariate logistic regression was conducted to analyse hyperlipidemia,hs-CRP and S100β as variables.The results showed that hyperlipidemia,hs-CRP,and S100β were risk factors for poor prognosis(OR=4.247,OR=13.796,OR=4.252,P<0.05).6.The levels of serum S100β and hs-CRP were(0.160±0.444)ng/ml and(4.76±2.37)mg/L in small infarction group,(0.236±0.134)ng/ml and(10.0±1.58)mg/L in middle infarction group,and(0.572±0.564)ng/ml and(11.37±1.66)mg/L in large infarction group respectively.There were significant differences in the levels of serum S100β protein and hs-CRP between the three groups(P<0.05).7.Compared with different degrees of neurological impairment,the levels of serum S100β protein and hs-CRP in mild neurological impairment group were(0.163±0.051)ng/ml and(5.24±2.79)mg/L,those in moderate neurological impairment group were(0.222±0.123)ng/ml and(9.95±1.72)mg/L,and those in severe neurological impairment group were(0.552±0.533)ng/ml and11.48±1.75)mg/L,respectively.There were significant differences in the levels of serum S100β protein and hs-CRP between the three groups(P<0.05).8.There was a positive correlation between serum S100β protein and NIHSS score and between serum hs-CRP and NIHSS score,and the difference was statistically significant(r =0.486,P<0.05,r = 0.775,P<0.05).Conclusion 1.S100β protein and Hs-CRP are related to the occurrence of cerebral infarction.2.Hyperlipidemia,Hs-CRP,and S100βwere risk factors for poor prognosis.3.S100β protein and Hs-CRP are related to the volume of cerebral infarction.4.Serum S100β protein and Hs-CRP can predict the clinical outcome of patiens with cerebral infarction at 3 months.