摘要
Abstract
Objective To investigate the serum bilirubin level in patients with acute cerebral infarction and its relationship with the prognosis. Methods A total of 177 patients with acute cerebral infarction (onset ≤2 weeks) were met the diagnostic criteria, 38 patients whose basic information were matched but without acute cerebral infarction (onset >2 weeks) , and 102 controls were selected. The serum bilirubin level and direct bilirubin level were detected at 72 hours after admission in all groups, the indirect bilirubin value was calculated, and the biochemical indexes, such as blood lipids, blood glucose, high sensitive C-reactive protein and fibrinogen ( FIB) were detected. Neurological deficit in the acute cerebral infarction group was assessed on the day of admission using the National Institutes of Health Stroke Scale (NIHSS). The prognostic evaluation was conducted using the modified Rankin scale (mRs) at 3 months after the onset of stroke. Results (I)The serum bilirubin and direct bilirubin levels in the acute cerebral infarction group were significantly higher than those in the non-acute cerebral infarction group ( P < 0. 05 ) and control group or ( P < 0. 01) , and the indirect bilirubin level only higher than that of the non-acute cerebral infarction group (P < 0. 05 ). The mean level of the three kinds of serum bilirubin in the non-acute cerebral infarction group was lower than that in the control group; however, there was no significant difference. ②With the increased severity of neurological deficit in the acute cerebral infarction group, the meanlevels of the 3 kinds of bilirubin tended to increase, however, there was no significant difference ( P < 0. 05 ). ③Three months after the onset, both the serum total bilirubin and direct bilirubin levels at admission in patients with good prognosis ( mRs, 0 to 2) in the acute cerebral infarction group were higher than those with poor prognosis (mRs, 3 to 5). The differences were statistically significant (P > 0. 05). ④Multivariate logistic regression analysis showed that the increased serum total bilirubin level was independently associated with the good prognosis ( OR, 0. 807, 95% C/: 0. 718 - 0. 907. P < 0. 01 ). Conclusion The serum bilirubin levels showed stressful increase in patients with acute cerebral infarction. The increased serum bilirubin level is not significantly associated with the severity of neurological deficit, but it is associated with good prognosis. The increased serum bilirubin level may be a protective defense response of the body for stroke events.关键词
脑梗死/胆红素/预后/急性期Key words
Brain infarction/ Bilirubin/ Prognosis/ Acute stage
