Assessment Of Serum IL-1β,IL-6,hs-CRP And Systemic Immunoinflammatory Index (SII) Studies On The Severity And Prognosis Of Acute Ischemic Stroke

Objective: This study focused on the relationship between serum interleukin-1β(IL-1β),interleukin-6(IL-6),supersensitive C-reactive protein(hs-CRP)and systemic immunoinflammatory index(SII)levels at admission and the degree of neurological deficits at admission and prognosis at 3 months after onset in patients with acute ischemic stroke(AIS),with the aim of identifying the most reliable prognostic indicators for acute cerebral infarction predictor.Methods: This study consecutively included 110 patients with acute cerebral infarction in the anterior circulation hospitalized in the Department of Neurology of Xianyang Hospital of Yan’an University from October 2020 to October 2022,and 30 outpatients with outpatient health check-ups in our hospital during the same period were selected.Baseline and laboratory data were collected from patients with acute cerebral infarction within 24 hours,and patients’ modified Rankin(m RS)scores were recorded after 3months.m RS <3 was defined as good prognosis,and m RS ≥3 was defined as poor prognosis.The National Institutes of Health Stroke Scale(NIHSS)score was used to assess the severity of neurological injury at admission.Two-sample independent t-tests and rank sum tests were used to compare the above data between the two groups for any differences,and Spearman analysis was used for correlation analysis between inflammatory factors and NIHSS scores at admission.Multi-factor binary logistic regression was used to analyze the factors influencing the short-term prognosis of neurological function in patients.roc curve analysis was used to compare whether there was any difference between hs-CRP and SII predicting prognosis of cerebral infarction at admission and at 90 days.Results:1.Comparison of baseline data between control group and experimental groupThere were no statistically significant differences in gender,age,BMI,systolic blood pressure,diastolic blood pressure,smoking,alcohol consumption,UA,TG,TC,HDL,HCY,and monocytes between the two groups and(P > 0.05),while the differences in GLU,LDL,neutrophils,lymphocytes,platelets,IL-1β,IL-6,hs-CRP,and SII were statistically significant(P < 0.05).2.Correlation analysis between serum IL-1β,IL-6,hs-CRP,SII and NIHSS scores at the time of admissionSerum IL-1β,IL-6,hs-CRP,and SII were positively correlated with NIHSS scores at admission in patients with acute cerebral infarction(r values were 0.2743,0.6016,0.5284,and 0.7579,respectively;P < 0.05).3.Multi-factor logistic regression analysis affecting the prognosis of neurological function of patients at 3 monthsWhether the prognosis of neurological function was good at 3 months of onset was used as the dependent variable,and IL-1β,IL-6,hs-CRP SII,lymphocytes,neutrophils,platelets,fasting glucose,NIHSS at admission,and SII as independent variables,and multifactorial regression analysis was performed at the α=0.05 level.The results showed that SII(OR=2.023,95% confidence interval 1.021-3.025,P=0.024)and IL-6(OR=1.524,95% confidence interval 1.006-18.922,P=0.049)were independent risk factors for poor prognosis of neurological function in patients at 3 months.4.ROC curve analysis of IL-6 and SII at admission and at 3 monthsComparison of ROC curves between IL-6 and SII at admission showed no significant difference(Z=1.576,AUC difference: 0.072,95%CI: 0.018-0.162,P=0.115).At 3 months,ROC curve comparison between IL-6 and SII showed significant difference(Z=2.257,AUC difference: 0.105,95% confidence interval: 0.014-0.196,P=0.024).5.Comparison of poor prognosis between low SII group and high SII groupBased on the best critical value of the ROC curve of SII at 3 months,546.12,we divided the patients into low SII group(SII ≤546.12)and high SII group(SII >546.12).There were 36 cases in the low SII group,of which 30 cases(83.33%)had a good prognosis and 6 cases(16.67%)had a poor prognosis;There were 104 cases in the high SII group,of which 79 cases(75.9%)had a good prognosis and 25 cases(24.04%)had a poor prognosis;compared with the low SII group,the high SII group had a significantly higher number of poor prognosis,and it was statistically significant P < 0.05.Conclusion:1.IL-1β,IL-6,hs-CRP and SII were correlated with the degree of neurological impairment in patients with acute ischemic stroke.2.Higher levels of SII and IL-6 were associated with poor short-term outcomes in patients with acute ischemic stroke.3.SII was superior to IL-6 in predicting short-term prognosis of patients with acute ischemic stroke.