Predictors of systemic inflammatory response syndrome in patients with acute ischemic stroke

Objective To investigate the predictors of systemic inflammatory response syndrome (SIRS) in patients with acute ischemic stroke. Methods The patients with acute ischemic stroke admitted to hospital from January 2010 to April 2014 were enrolled. The demographics, vascular risk factors, baseline clinical data, and laboratory tests in both groups were collected. Flow cytometry was used to analyze the peripheral blood T helper cell (Th) subgroup. Double antibody sandwich enzyme-linked immunosorbent assay was used to detect the levels of peripheral blood interferon-γ (IFN-γ) and interleukin-4 (IL-4). Results A total of 143 patients with acute ischemic stroke were enrolled, including 56 in a SIRS group and 87 in a non-SIRS group. Univariate analysis showed that there were significant differences in the history of hypertension, history of stroke, baseline systolic blood pressure, low-density lipoprotein cholesterol level, National Institutes of Health Stroke Scale (NIHSS) score, percentage of Th1 cells, and IFN-γ concentration in patients of both groups (all P<0.05). Multivariate logistic regression analysis showed that the NIHSS score ≥6 (odds ratio [OR] 2.40, 95% confidence interval [CI] 1.24-5.15, P=0.008), decreased percentage of Th1 cells (OR 2.81, 95% CI 1.51-6.83, P=0.013), and decreased IFN-γ concentration (OR 4.63, 95% CI 1.01-9.72, P=0.004) were the independent predictive factors for occurring SIRS in patients with acute ischemic stroke. Conclusions Severe neurological deficit, decreased percentage of Th1 cells or decreased IFN-γ level may increase the risk of acute ischemic stroke patients with SIRS. Key words: Stroke; Brain Ischemia; Systemic Inflammatory Response Syndrome; Risk Factors