The Relationship Between Hs-CRP And Short-term Prognosis In Patients With Acute Cerebral Infarction

Objectives To explore the relationship between hs-CRP and short-term prognosis inpatients with acute cerebral infarction. The mechanism of hs-CRP in acute cerebralinfarction will be exploredMethods Consecutively collecting252acute cerebral infarction patients during April,2012to October,2013in the second nerval medical department ward of Hebei UnitedUniversity Hospital. All the cases were in line with the diagnostic criteria revised in1995Fourth National Conference of Cerebrovascular Diseases and were confirmed by CT orMRI. Serum samples were collected within24hours of admission to measure the level ofhs-CRP.Meanwhile collected the following information: gender,age,Past MedicalHistory(cerebral infarction,hypertension,type2diabetes, coronary heart disease), historyof smoking and drinking,imageological diagnosis and the laboratory test results, et al. Weevaluated the acute cerebral infarction patients of neurological impairment and self-careby using NIHSS scale stroke and Modified Rankin scale, respectively, at admission and14days. Study outcome was defined as death or disability (MRs≥3). Statistical analysiswas performed using SPSS17.0software. Measurement data were analyzed by t-test orrank sun test. Numeration data were analyzed by chi-square test. All the patients weredivided into four groups by quartile method according to the serum hs-CRP levels,Unadjusted and multiple adjusted logistic regression models were used to analyze therelationship between hs-CRP and short-term prognosis in patients with acute cerebralinfarction. Sensitivity and specificity were analyzed by ROC curve.Results1The medical history rates of hypertension and the NIHSS scores, FIB level,WBC level were higher in the group of high hs-CRP.2The poor prognosis rate56.94%in high hs-CRP group was significantly higher than28.33%in low hs-CRP group, thedifference was statistically significant (P＜0.001).3All the patients were divided intofour equal parts by quartile method according to the serum hs-CRP levels to compare therisk of poor prognosis among the different serum hs-CRP level groups. We found that theproportion of poor prognosis gradually increased with the increased level of serum hs-CRP. High serum hs-CRP level was directly associated with a high risk for poorprognosis. As compared to the group of hs-CRP≤0.30mg/L the odds ratios (95%CI) forpoor prognosis in the groups of1.32～3.40mg/L,≥3.41mg/L were3.76(1.58～8.97), 11.93(4.95～28.75), respectively. Multivariate logistic regression(adjusted forhypertension, drinking, infarction position, complication, dyslipidemia, stroke type,NIHSS score, age, FIB and FBG) still showed that: cerebral infarction patients hadincreased risk of poor prognosis with the gradually increased serum hs-CRP levels. TheRR value and95%CI was higher in hs-CRP level≥3.41mg/L group［4.22(1.09～16.615)］than in hs-CRP level≤0.30mg/L group.4The sensitivity and specificity ofhs-CRP were higher for identifying poor prognosis of acute cerebral infarction. The areaunder the ROC curve was0.722. hs-CRP cutoff value of3.53identified poor prognosiswith a sensitivity of76.0%and specificity of63.1%.Conclusions Elevated hs-CRP levels is risk factor for early poor prognosis in patientswith acute ischemic stroke. Indicating that hs-CRP may play a role in the onset anddevelopment of acute cerebral infarction.