Features of the inflammatory and metabolic profile of patients in the acute period of ischemic stroke

Abstract

Objective — the analyze the indicators of the blood lipid spectrum and nonspecific systemic inflammation in patients in the acute period of ischemic stroke and determine the relationship between the concentration of cytokines in blood plasma and the survival of patients with ischemic stroke.Methods and subjects. In the clinical included 151 patients (mean age 61.5 ± 8.2 years), who were distributed into 2 groups: the first group consisted of 85 patients with acute ischemic stroke; the second group — 66 patients with chronic cerebral ischemia. All patients were assessed for their inflammatory and metabolic status by lipids, total fibrinogen, C‑reactive protein (CRP) and cytokines (IL‑6 and TNF‑a) in peripheral blood. We analyzed the possibility of correlation of these parameters with each other and with the severity of neurological deficit according to NIHSS.Results. Patients of both groups showed changes in the blood lipid spectrum, typical for atherogenesis, which were significantly more pronounced in ischemic stroke. In patients of the 1st group revealed an increase in the level of fibrinogen (p = 0.04), which indicates an increase in the activity of coagulation hemostasis. During the study of the cytokine system in the acute period of ischemic stroke, hyperproduction of CRP (p < 0.001) and pro‑inflammatory cytokines (p < 0.001) was revealed. High concentrations of CRP and low concentrations of IL‑6, TNF‑a are associated with severe neurological deficiency in the acute period of stroke. In lethal patients, the levels of IL‑6 (р < 0.001) and TNF‑a (р < 0.001) were lower, and the level of CRP (р < 0.001) was significantly higher than in surviving patients with ischemic stroke. The threshold values of the concentration of CRP (≥ 24 mg/l), IL‑6 (≤ 57 pg/l) and TNF‑a (≤ 42 pg/l) in the blood of patients with ischemic stroke were determined.Conclusions. The obtained results indicate the potential role of determining the content of CRP, IL‑6 and TNF‑a in improving the stratification of the risk of death in patients with ischemic stroke.