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Abstract
This study was done to asses the relation between serum levels of C-reactive protein in patient with acute stroke either ischemic or hemorrhagic and its relation to diabetes mellitus. This study was done in stroke unit of Internal Medicine Department and Biochemistry Department in Zagazig University during the period from september 2005 to August 2006.One hunderd Subjects (80 Patients and 20 apparently healthy controls) were included in this study and sub divided into five Groups:
• Group I: (20 ischemic stroke patients without diabetes mellitus).
• Group II: (20 hemorrhagic stroke patients without diabetes mellitus).
• Group III: (20 ishcmeic stroke patients with diabetes mellitus).
• Group IV: (20 hemorrhagic stroke patients with diabetes mellitus).
• Group V: (20 apparently healthy controls).
1.Detailed history taking with special stress on past medical history obtained from the patients or their relatives to establish the presene of any risk factor for stroke and to verify inclusion and exclusion criteria.
2.Complete general and neurological examination.
3. Lab investigations to verify the aim of the work
•CBC
•Kidney function tests.
• Liver function tests.
• PT - PTT - INR
•Fasting and 2 h post prandial blood glucose levels.
4. Assay of serum level of CRP using of CRP turbidometry.
5. Computed tomography of the brain.
The results showed that :
1. There is a significant difference between the studied groups regarding ischemic heart disease (IHD) and a highly significant difference between them regarding hypertension.
2. There was no significant difference between ischemic stroke patients or hemorrhagic stroke patients regarding age, sex, hypertension diabetes mellituse, atrial fibrilliation (AF) and ischemic heart disease (IHD).
3. There was no significant difference between diabetic (III+IV) and non diabetic patients (I+II) regarding the age, sex, hypertension, ischemic heart disease (IHD) and atrial fibrilliation (AF).
4. There was a highly significant difference in mean values of CRP between patietns compared to conrol group.
5. The mean values of CRP were significantly higher in ischemic patients more than hemorrhagic stroke patients.
6. The mean values of CRP were significantly higher in diabetic groups (III+IV) patients more than non diabetic patients (I+II).
7. Ischemic stroke patients with diabetes mellitus had a higher mean values of CRP more than that ischemic stroke patients without diabetes mellitus and hemorrhagic stroke patients with or without diabetes mellitus.
8. Hemorrhagic stroke patients with diabetes mellitus, had a higher mean values of CRP compared to that hemorrhagic stroke patients without diabetes mellitus.
9. Serum CRP values increased significantly with the increased number of risk factors in all group of patients except in group II.
10. Using a cutoff value of serum CRP values of 12 mg/L that no diabetic patients had serum CRP levels below this value.
CONCLUSION
In conclusion, we found that patients suffering from ischemic stroke had a higher levels of CRP more than that suffering from hemorrhagic stroke.
Furhtermore, diabetes was significantly associated with elevated levels of circulating CRP in ischemic stroke, moreover, patients with hemorrhagic stroke with diabetes mellitus had a higher levels of CRP more than hemorrhagic stroke patients without diabetes mellitus.