Prediction of Serum 25-Hydroxyvitamin D for Outcome of Acute Ischemic Stroke in Emergency / 中国康复理论与实践

Objective:To explore the change of serum 25-hydroxyvitamin D [25(OH)D] and prediction for outcome of acute ischemic stroke in emergency. Methods:From October, 2017 to September, 2019, 224 patients with acute ischemic stroke in emergency and 240 healthy controls were detected serum 25(OH)D within 24 hours after enrollment. The patients were assessed with National Institute of Health Stroke Scale (NIHSS) and Nutritional Risk Screening 2002 (NRS2002), and measured biochemics within 24 hours after admission. They were assessed with modified Rankin Scale (mRS) 180 days after stroke, and divided into favourable group (mRS ≤ 2, n = 106) and unfavourable group (mRS > 2, n = 118). The factors related with the outcome were analyzed with Logistic regression, and the prediction of 25(OH)D for the outcome were analyzed with receiver operator characteristic (ROC) curve. Results:Serum 25(OH)D was less in the patients than in the controls (Z = 4.296, P < 0.001), and less in the unfavourable group than in the favourable group (Z = 5.876, P < 0.001). Serum 25(OH)D (OR = 0.925, P < 0.05) was related with the outcome even controlling the impacts of age, sex, nutritional risk, infarct volume, scores of NIHSS, etc. The area under curve for serum 25(OH)D predicting outcome was 0.795 (P < 0.001). The cut-off point of prediction was 13.17 ng/ml, with the Yoden index of 0.548, which yielded a sensitivity of 0.746 and a specificity of 0.802. Conclusion:Serum 25-hydroxyvitamin D may predict the outcome 180 days after acute ischemic stroke, which may help for risk stratification in emergency.

Advance in Relationship between Obstructive Sleep Apnea and Stroke (review) / 中国康复理论与实践

Obstructive sleep apnea (OSA) may increase the risk of stroke, and patients with stroke are also prone to suffer OSA. Advanced age, high body mass index, male, hypertension and diabetes are risk factors for stoke in OSA patients, and severe sleep apnea may also be associated with poor functional outcomes of stroke. Potential pathophysiological mechanisms may include endothelial dysfunction, abnormal neuromodulation, metabolic abnormalities, change of cerebral hemodynamic and hypercoagulability. Continuous positive airway pressure (CPAP) is the standard treatment for patients with moderate to severe OSA, but it has not been proved that CPAP can reduce the risk of cardiovascular events including stroke.