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Objective To investigate the pattern of fluctuations and clinical significance of fasting serum insulin(FINS) and C-peptide(CP) levels in patients with different subtypes of acute cerebral infarct(ACI) and its relationship with serum lipid. Methods FINS and CP were measured in 152 ACI patients by chemiluminescent immunoassay. All ACI patients were classified into 5 major ischemic stroke subtypes according to the trial of org10172 in acute stroke treatment(TOAST) criteria. And then the relationship between FINS and CP level and serum lipid in different TOAST subtypes were analysed. Results The percentage of each ischemic stroke TOAST subtype was as follow: stroke of undetermined etiology 40.13%, small-vessel occlusion 34.21%, cardioembolism 5.26%, large-artery atherosclerosis 15.79%, and stroke of other determined etiology 4.61%. Among 5 major stroke subtypes, large-artery atherosclerosis patients had the highest levels of FINS and CP. The levels of FINS and CP in small-vessel occlusion were (8.237?5.144) ?U/ml and (1.761?0.975)ng/ml,respectively. Stroke of other determined etiology subtypes were associated with the lowest levels of FINS and CP. Apparently, other factors, such as TC, TG, LDL, SBP, DBP, age and HDL, could also affect the levels of FINS and CP in serum. Conlusions Levels of FINS and CP varied in different subtypes of ACI. There was a significant correlation among insulin resistance, hyperinsulinemia(HIS) and lipid metabolic abnormality in ACI.
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BACKGROUND: There are so many experimental and clinical researches on levels of nitrogen monoxide (NO) in serum and endothelins in plasma of patients with stroke; however, ratio and significance between them are still unclear.OBJECTIVE: To observe dynamic changes of levels of NO in serum and endothelins in plasma of patients with stroke.DESIGN: Case-controlled observation.SETTING: Neurological Department and Clinical Neurological Laboratory of the Second Hospital affiliated to Suzhou University.PARTICIPANTS: A total of 216 patients with acute cerebral infarction including 133 males and 83 females and 112 cases with cerebral hemorrhage including 68 males and 44 females were selected from Neurological Department of the Second Hospital affiliated to Suzhou University from September 1999 to December 2001. Another 106 subjects including 63males and 43 females were regarded as healthy control group.METHODS: Contents of NO in serum and endothelins in plasma were measured on 328 patients with stroke and 106 healthy subjects in the courses of 1-3 days, 1, 2, 4, 8 and 12 weeks with nitrate reductase and radio-immunity methods, respectively.MAIN OUTCOME MEASURES: Contents of NO in serum and endothelins in plasma; ratio between NO in serum and endothelins in plasma (NO/endothelins).RESULTS: ① As compared with those in the control group, content of NO in serum of patients with cerebral infarction and cerebral hemorrhage was decreased and reached the lowest value during acute period (within 1-3 days), and then increased gradually and closed to the normal level at about 4 weeks. In addition, content of endothelins in plasma was increased obviously during acute period, reached the peak at 2 weeks, and then decreased gradually. The level was still high at stage of recovery and closed to normal value within 4-8 weeks. ② As compared with that in the control group, NO/endothelins was decreased in cerebral infarction group at the courses of 1-3 days (P ＜ 0.05), reached the lowest value at 1 week (P ＜ 0.001), and increased to the normal level at 2 weeks. Moreover,NO/endothelins was remarkably decreased in cerebral hemorrhage group at the courses of 1-3 days (P ＜ 0.001), reached the lowest value at 1week (P ＜ 0.001), and increased gradually. The changes of course were great and the level reached above normal value at 8 weeks. There was significant difference of dynamic changes of NO/endothelins between cerebral hemorrhage group and cerebral infarction group (P ＜ 0.05).CONCLUSION: NO and endothelins play an important role in onset and development of ischemic cerebrovascular disease and hemorrhagic cerebrovascular disease, and their contents are related to prognosis.
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Objective:To detect depression in stroke patients and observe its influence on rehabilitation of neurological function and the effect of fluxetine therapy Methods:132 acute stroke patients (78 with infarction, 54 with hemorrhage) were included in the study After inclusion, we did five times of assessments at the end of 2 weeks, 1 month, 3 months, 6 months and 1 year respectively using HAMD assessment to determine whether there had depression or not, as well as SSS (modified Edingburgh-Scandinavian Scoring Scale) for neurological function, ADL (activity of daily living), and self rate depression and anxiety (Zung's self rate depression scale and anxiety scale) Of those with depression, 25 received fluxetine 20mg/d, other 32 with only regular treatment of stroke as control Results:According to results of HAMD, 59 of the 132 had depression (44 7%) The rate of depression had no significant difference between male and female, between those with infarction and with hemorrhage Depression had negative influence on neurological function and activity of daily living Depression had no relation to location, size and unilateral or bilateral of the loci Fluxetine improved depression, neurological function and activity of daily living from 3 months after stroke; its influence on neurological impairment was most significant at 1 year after stroke Conclusion: Post stroke depression is common after cerebral infarction or hemorrhage, it has negative influence on rehabilitation of neurological function and activity of daily living Fluxetine improves both neurological impairments and activity of daily function, as the same time of its improvement of depression
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Objective To evaluate the value of 99m Tc-TRODAT-1 SPECT DAT imaging in the early diagnosing of Parkinsons disease (PD).Methods Eleven patients (9 PD and 2 possible PD) and eighteen healthy subjects matched by sex and age were studied with 99m Tc-TRODAT-1 SPECT DAT imaging. Striatum specific uptake of 99mTc-TRODAT-1 was calculated according to the ratio of DAT uptake in striatum (ST) and cerebellum (CB). Results In the hemi-Parkinsons disease group, the DAT specific uptake of 99mTc-TRODAT-1 was significantly lower (P＜0.01) in contralateral than in ipsilateral striatum to the clinically symptomatic side. There was significant decrease (p＜0.01) of striatum DAT uptake in patients with hemi-PD compared to the controls.Conclusions 99mTc-TRODAT-1 SPECT DAT imaging may help to confirm the diagnosis of PD at the early stage.
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Objective To investigate the changes of the serum high sensitive C-reactive protein (hs-CRP)level in patients with acute cerebral infarction (ACI) and study the relationship between hs-CRP level and ischemic stroke subtypes according to the trail of org10172 in acute stroke treatment (TOAST) criteria.Methods The serum hs-CRP was measured in 152 ACI patients by immunonephelometrical method. All ACI patients were classified into 5 major ischemic stroke subtypes based on TOAST criteria. And then the relationship between hs-CRP level and their TOAST subtypes were analysed.Results The percentage of each ischemic stroke TOAST subtypes of 152 patients was as following: stroke of undetermined etiology 41.45%, small-vessel occlusion 34.87%, cardioembolism 5.26%, large-artery atherosclerosis 15.79%, and stroke of other determined etiology 2.6%. Among 5 ischemic stroke subtypes, cardioembolism patients were related to the highest positive rate of hs-CRP(87.50%) and the highest hs-CRP level [(11.60?7.85)mg/L]. The hs-CRP level in large-artery atherosclerosis or stroke of other determined etiology were (10.77?4.27) mg/L or (6.45?3.25) mg/L respectively, Stroke of undetermined etiology and small-vessel occlusion subtypes were associated with the lowest positive rate of hs-CRP(38.10%, 37.74%) and the lowest hs-CRP level [(4.09?5.65)mg/L,(3.99?0.56)mg/L]. Apparently, other factors, such as age, systolic blood pressure, cholesterol, triglyeride, fasting blood sugar and fibrinogen, could also affect the hs-CRP level in serum(r=0.1640、0.2489、0.2066、0.1866、0.3029、0.2224,all P