ABSTRACT
Objective:To investigate the correlation between stress hyperglycemia ratio (SHR) and poor outcome of successful recanalization after endovascular treatment in patients with acute ischemic stroke.Methods:From January 2019 to October 2022, patients with acute ischemic stroke received endovascular treatment and successful recanalization in the Second People’s Hospital of Lianyungang were included retrospectively. SHR was defined as the fasting blood sugar and glycosylated hemoglobin ratio. At 90 d after procedure, the outcome of patients was evaluated using the modified Rankin Scale score. 0-3 was defined as good outcome, and >3 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent risk factor for poor outcome. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SHR for 90 d poor outcome in patients with successful recanalization after endovascular treatment.Results:A total of 159 patients were enrolled, including 98 males (61.6%), aged 69.8±8.9 years old. The baseline National Institutes of Health Stroke Scale (NIHSS) score was 12.6±4.3, and SHR was 1.17±0.46. One hundred and five patients (66.0%) had good outcome, while 54 (34.0%) had poor outcome. There were statistically significant differences in SHR, fasting blood glucose, glycosylated hemoglobin, baseline NIHSS score and the proportion of patients with poor collateral circulation and symptomatic intracranial hemorrhage between the poor outcome group and the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that SHR was an independent predictor of poor outcome (odds ratio 2.254, 95% confidence interval 1.136-4.278; P<0.001). The ROC curve analysis showed that the area under the curve of SHR for predicting poor outcome was 0.726 (95% confidence interval 0.648-0.804; P<0.001), which was higher than fasting blood glucose and glycosylated hemoglobin. The optimal cutoff value for SHR was 1.21, and the sensitivity and specificity for predicting poor outcomes were 66.23% and 75.82%, respectively. Conclusion:SHR is associated with the poor outcome of successful recanalization after endovascular treatment in patients with acute ischemic stroke and can be used as a potential predictor.
ABSTRACT
Objective To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) on admission for early neurological deterioration (END) in patients with lacunar stroke.Methods Patients with acute lacunar stroke admitted to the Department of Neurology,the Second People's Hospital of Lianyungang from June 2015 to October 2017 were enrolled retrospectively.END was defined as an increase of ≥2 in the National Institutes of Health Stroke Scale (NIHSS) score within 72 h of admission.Multivariate logistic regression analysis was used to determine the independent risk factors for END.The receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for END in patients with lacunar stroke.Results A total of 309 patients with acute lacunar infarction were enrolled,including 180 males (58.2％),aged 59.7 ±7.3 years;65 patients (21.0％) in END group and 244 (79.0％) in non-END group.Multivariate logistic regression analysis showed that after adjusting for other confounders,NLR was an independent risk factor for END in lacunar stroke (odds ratio 4.508,95％ confidence interval 3.128-7.547;P＜0.001).ROC curve analysis showed that the area under the curve of NLR predicting END in patients with lacunar stroke was 0.725 (95％ confidence interval 0.671-0.776;P ＜ 0.001);the optimal cut-off value was 2.32,the sensitivity of predicting END was 61.21％,and the specificity was 72.54％.Conclusion The elevated NLR after admission is an independent risk factor for END in patients with lacunar stroke,which has certain value for early identification and prediction of END.
ABSTRACT
Objeetive To investigate the associations of plasma homocysteine (Hcy) level and methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism with white matter lesion (WML) in a Chinese Han population.Methods A toal of 104 patients with WML and 74 controls were recruited.Hcy level and MTHFR gene C677T polymorphism were determined.The degree of severity of the WML was evaluated using a modified Scheltens scale.Results The plasma Hcy level (median and interquartile range,16.81 [11.33-18.92] μmol/L vs.11.40 [8.28-14.23] μmol/L;Z =5.415,P =0.001) and the proportion (85.6％ vs.54.1％;x2 =28.535,P ＜ 0.001) of patients with hyperhomocysteinemia (HHcy) in the WML group were significantly higher than those in the control group.However,there were no significant differences in the frequencies of C677T genotype (x2 =1.255,P =0.534) and allele (x2 =1.057,P =0.304).There are 89 patients with HHcy and 15 patient with normal Hcy in 104 patients with WML.The modified Scheltens scale score in the HHcy subgroup was higher that in the normal Hcy subgroup (8.06 ±5.61 vs.5.80 ±2.98;t =2.324,P=0.027).Multivariate logistic regression analysis showed that age (odds ratio[OR] 1.090,95％ confidence interval [CI] 1.049-1.133;P=0.001),hypertension (OR 1.719,95％ CI 1.645-2.307;P ＜ 0.001),and HHcy (OR 1.128,95％ CI 1.044-1.219;P =0.002) were the independent risk factors for white matter lesions.Conclusions HHcy is an independent risk factor for WML,whereas the MTHFR gene C677T polymorphism is not associated with WML.
ABSTRACT
Objective To investigate the correlation between serum homocysteine (Hcy) and macrophage migration inhibitory factor(MIF) with carotid atherosclerosis and between serum Hcy and MIF ,and to study whether serum Hcy influence the carotid atherosclerosis formation by MIF .Methods 258 inpatients and outpatients were performed the color ultrasound examination to ob-serve the carotid arterial vascular anatomic form ,endomembrane circumstance ,plaque and the plaque echo nature ,and the carotid in-tima-media thickness(IMT) was measured .According to the results of color ultrasound ,the cases were divided into three groups :IMT normal group(control group) ,thickening group and plaque group .According to the plaque echo characteristics ,the plaque group was redivided into two subgroups :stable plaque group and unstable plaque group .Serum Hcy and MIF levels and biochemical parameters were measured simultaneously in all cases .The differences of serum Hcy and MIF levels were compared between groups .The correlation coefficients among serum Hcy levels ,MIF levels and IMT were calculated .Results The serum Hcy and MIF levels in the control group ,thickening group and plaque group were increased in turn ,the difference among groups was statisti-cally significant(P<0 .01);which in the unstable plaque group was significantly higher than that in the stable plaque group ,the difference between them was statistically significant (P<0 .01) .The positive correlation was found among serum Hcy levels ,serum MIF levels and IMT (r=0 .584 ,0 .562 ,0 .607 ,P<0 .01) .Conclusion The serum Hcy and MIF levels are closely related with the carotid atherosclerosis degree and the plaque stability ;the serum Hcy and MIF levels are positively correlated with the carotid arte-rial IMT ;serum Hcy is positively correlated with the MIF level ,Hcy may cause the carotid atherosclerosis formation via MIF .