Nutritional status in acute stage ischemic stroke and its relation to disease severity and prognosis of patients
10.3785/j.issn.1008-9292.2015.01.010
- VernacularTitle:缺血性卒中患者急性期营养代谢相关指标的变化
- Author:
Qing HONG
1
;
Li-San ZHANG
;
Yin CHEN
;
Xu-Dong HE
;
Xing-Yue HU
Author Information
1. 浙江大学医学院附属邵逸夫医院神经内科
- Keywords:
Stroke;
Brain ischemia;
C-Reactive protein;
Complement C3;
Prealbumin;
Hydrocortisone
- From:
Journal of Zhejiang University. Medical sciences
2015;(1):61-66
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the nutritional status in acute stage ischemic stroke and its relation to disease severity and prognosis of patients .Methods: Fifty patients with ischemic stroke were admitted in hospital within 48 h after onset.National Institute of Health stroke scale ( NIHSS ) was used to assess the severity of stroke . Physical index and laboratory index were measured on d 1 , d7 and d14 after admission . Physical index included body weight , body mass index , triceps skin folds , upper arm circumference and arm muscle circumference .Laboratory index included prealbumin , high sensitivity C-reactive protein (hs-CRP), complement C3 and cortisol.The severity of metabolic disturbance was expressed as the difference of biochemical indexes between the d7 and d1.All cases were followed up for 6 months.The prognosis of stroke was evaluated with modified Rankin ( mRankin) scores.Results:No significant changes of physical indexes were found between d 7 and d1. The levels of prealbumin and complement C3 on d7 after admission were significantly decreased compared to d 1 (198.8 mg/L ±20.3 mg/L vs 286.7 mg/L ±23.8 mg/L and 0.6 g/L ±0.1 g/L vs 1.0 g/L ±0.1 g/L, respectively , both P<0.05 ) .The levels of hs-CRP and cortisol at d7 were significantly increased compared to d 1 ( 495.2 nmol/L ±39.5 nmol/L vs 24.1 mg/L ±5.2 mg/L and 396.4 nmol/L ±41.3 nmol/L vs 5.1 mg/L ±1.2 mg/L, respectively , both P<0.05 ) .On d14 after admission hs-CRP(13.2 mg/L ±4.5 mg/L) and cortisol levels (463.4 nmol/L ±32.1 nmol/L) were still significantly higher than d1 (both P<0.05).However, there were no difference in prealbumin (259.2 mg/L ± 22.8 mg/L) and complement C3 (0.8 g/L ±0.2 g/L) levels between d1 and d14 after admission .Correlation analysis revealed that the NIHSS scores and mRankin scores were correlated with nutrition metabolism disturbances ( P <0.05 ) . Conclusion:Nutrition metabolism disturbances in patients with acute ischemic stroke are related to the disease duration , the severity and prognosis of stroke .
