ABSTRACT
Objective To study the influencing factors of clinical outcome in elderly acute ischemic stroke (AIS) patients after intravenous thrombolysis.Methods One hundred and fifty-one AIS patients admitted to our hospital for intravenous thrombolysis were divided into good outcome group (n=77) and poor outcome group (n=74) according to their modified Rankin scale score 3 months after the onset of AIS.The baseline data,thrombolysis time window,NIHSS score and ischemic stroke typing before thrombolysis,early symptom improvement,cerebral hemorrhage after thrombolysis were compared between the two groups.Results The serum levels of blood glucose and CRP,NIHSS score≥9 before thrombolysis,incidence of AF and cerebral hemorrhage were significantly higher in poor outcome group than in good outcome group (P＜ 0.05,P＜0.01).Multivariate logistic regression analysis showed that NIHSS score,OCSP typing,blood glucose before thrombolysis,24 h symptom improvement were the independent influencing factors of clinical outcome in elderly AIS patients (OR =1.262,95 ％ CI:1.075-1.482,P =0.005;OR =0.203,95％CI:0.066-0.628,P=0.006;OR=1.264,95％CI:1.042-1.532,P=0.017;OR=25.764,95％CI:5.131-129.361,P=0.000).Conclusion NIHSS score,OCSP typing,blood glucose before thrombolysis and 24 h symptom improvement are the independent influencing factors of clinical outcome in elderly AIS patients after intravenous thrombolysis.
ABSTRACT
Objective To explore the effectiveness of using middle-latency somatosensory evoked potentials (MLSEP) to predict the prognosis in patients with acute severe stroke. Methods MLSEP, shortlatency somatosensory evoked potentials (SLSEP), and Glasgow Coma Scale (GCS) were recorded in 70 acute severe supratentorial stroke patients within 1 week after onset. All patients were evaluated with modified Rankin Scale (mRS) and follow-up in 6 months after onset. SLSEP and MLSEP were recorded in 20 normal controls. The consistency between MLSEP, SLSEP, GCS and prognosis, as well as the prognostic authenticity of MLSEP, SLSEP, and GCS were analyzed. Results Bilateral N20, N35, and N60 exited in all normal controls. Some waves of MLSEP were absent in stroke patients, and the proportion of absent waves in ipsilateral MLSEP was higher than in contralateral MLSEP. The consistency between bilateral absence of N60 and unfavorable outcome ( Kappa = 0.828, P ＜ 0.01 ), and between bilateral absence of N60 and death ( Kappa = 0.686, P ＜ 0.01 ) was satisfactory. By using the prognostic authenticity analysis of predictors, the ipsilateral absence of N60 showed the highest sensitivity ( 100% ) for unfavorable outcome and death, which added 14.3% compared with the sensitivity of ipsilateral absence of N20 ( 85.7% ). Bilateral absence of N60 showed a high specificity of 100% for unfavorable outcome, which equaled bilateral absence of N20.However, it showed a lower specificity ( 82.9% ) for death, than bilateral absence of N20 (97.1% ).Conclusions MLSEP was able to reflect the degree of brain injury and showed higher sensitivity than SLSEP for predicting unfavorable outcomes. Therefore combined use of MLSEP and SLSEP in evaluating and predicting the outcomes in brain injuries is suggested.