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Journal of the Korean Neurological Association 2004;22(6): 577-582.
뇌경색 환자에서 혈장 C-reactive protein과 혈소판의 P-selectin 발현이 예후에 미치는 영향
오영미, 김대현 박경원 김상호 김재우 차재관
동아대학교 의과대학 신경과학교실, 울산대학교병원 신경과*
Prognostic Influence of Plasma C-reactive Protein and Platelet P-selectin Expression in Patients with Ischemic Stroke
Young-Mi Oh
Department of Neurology, Dong-A University College of Medicine, Busan; Department of Neurology, Ulsan University Hospital, Ulsan, Korea
Background: Inflammation and platelet activation are important pathological processes in ischemic stroke. However, little is known about their prognostic values in ischemic stroke. In this study, we investigated the 90 days prognostic influences of plasma C-reactive protein (CRP) and platelet P-selectin expression on the outcomes of ischemic stroke.
Methods: Between May 2001 and March 2002, Plasma CRP concentration and platelet P-selectin expression were evaluated for 24 hrs in 93 patients with first-ever ischemic stroke. Clinical outcomes were measured at 90 days by the Barthel index (BI). We examined the association between their values and the clinical outcomes and we adjusted the possible confounding factors using multiple logistic regression analysis.
Results: Of 93 patients, 31 patients showed poor clinical outcomes (BI<85). The poor clinical outcome was related with the initial CRP level (p<0.0001), platelet P-selectin expression (p=0.0004), neurologic deficit (p<0.0001), and leukocytes counts (0.0003). In multiple linear regression analysis, the CRP level (odds ratio, 2.833; 95 % CI, 1.216 to 6.317; p=0.012), and initial neurologic deficit (odds ratio, 1.8; 95 % CI, 1.136 to 2.818: p=0.012) were independently related with clinical outcome after 90 days of ischemic stroke onset.
Conclusions: CRP is an important predictable marker for poor clinical outcome in ischemic stroke. These findings are consistent with the hypothesis that inflammatory processes may be a critical factor for the progressing deterioration of ischemic stroke. Key Words: Stroke, Platelet, Inflammation