期刊
JOURNAL OF THE NEUROLOGICAL SCIENCES
卷 252, 期 1, 页码 29-35出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jns.2006.10.001
关键词
infection; adrenal gland; metanephrines; interleukins; cerebral ischemia
Experimental studies have recently suggested that acute ischemia may facilitate the appearance of fatal infections as part of a brain-induced immunodepression syndrome. However, the mechanisms and neurological consequences of infections complicating acute ischemic stroke have received much less attention at the bedside. The incidence of infection and death after non-septic stroke was compared in this prospective study with longitudinal changes of cytokines, leukocytes, normetanephrine (NMN) and metanephrine (MN) in 75 consecutive patients. In multivariate analysis, infection, n = 13 (17%), was associated with the upper quartile of MN (OR 3.51, 95% Cl 1.30-9.51), neurological impairment (NIHSS) on admission (OR 3.99, 95% Cl 1.34-11.8), monocyte count (OR 1.78, 95% Cl 1.13-2.79), and increased interleukin (IL)- 10 (OR 1.54, 95% CI 1.00-2.38). Mortality at 3 months, n 16 (21 %), was associated with increased levels of NMN on admission (OR 2.34 95% CI 1.15-4.76), NIHSS score (OR 2.57, 95% CI 1.29-5.11), and higher IL-6 levels (OR 1.29, 95% 1.00-1.67). These findings suggest that acute ischemic stroke is associated with an early activation of the sympathetic adrenomedullar pathway that lowers the threshold of infection and increases the risk of death. Moreover, these findings are independent of the blood borne effects of pro- and anti-inflammatory cytokines, and circulating leukocytes. (c) 2006 Elsevier B.V. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据