ABSTRACT
Objective To investigate the influencing factors of hematoma enlargement after spontaneous intracerebral hemorrhage. Methods The patients with spontaneous intracerebral hemorrhage were enrolled retrospectively in the study. The demographics, vascular risk factors, and baseline clinical data of the patients were collected. Hematoma enlargement was defined as CT scan within 48 h showed that the increased hematoma volume was more than >1/3 of the baseline. The demographics, vascular risk factors, and baseline clinical data of the hematoma enlargement group and the non-hematoma enlargement group were compared. Multivariate logistic regression analysis was use to identify the risk factors for hematoma enlargement. Results A total of 121 patients with spontaneous intracerebral hemorrhage were enrolled, including 69 males and 52 females, their ages were 24 to 89 years (mean 59.16 ±12.68). Forty-five patients (37.2%) had combined hypertension, 5 (4.1%) had diabetes, and 11 (9.1%) had hyperlipoidemia. Thirty patients (24.79%) had hematoma enlargement within 48 h. The time from ictus to the first CT scan was 4.21 ±1.57 h and the time from ictus to CT scan again was 34.78 ±6.90 h. Univariate analysis showed that the proportion of patients drinking alcohol (46.7% vs.26.4%; χ2 =4.313, P =0.038), as well as systolic blood pressure (174.53 ±20.02 mmHg vs.160.63 ±19.79 mmHg, t = -3.327, P = 0.001; 1 mmHg = 0.133 kPa), fasting blood glucose (7.67[6.70-9.47]mmol/L vs.6.78[5.81- 7.79]mmol/L; Z = -2.266, P =0.023), National Institutes of Health Stroke Scale (NIHSS) score (10.00[8.00-12.00] vs.5.00[3.00-8.00]; Z = -5.468, P < 0.001) in the hematoma enlargement group were significantly higher than those in the non-hematoma enlargement group, while low-density lipoprotein cholesterol (2.60[2.10- 2.91]mmol/L vs.3.00[2.60-3.41]mmol/L; Z = -3.905, P <0.001) was significantly lower than that in the nonhematoma enlargement group. Multivariate logistic regression analysis showed that baseline systolic blood pressure (odds ratio [OR] 1.036, 95% confidence interval [CI] 1.007-1.065; P =0.014) and NIHSS score (OR 1.310, 95% CI 1.111-1.544; P =0.001) were the independent risk factors for hematoma enlargement, while low –density lipoprotein cholesterol (OR 0.279, 95% CI 10.105-0.742; P =0.011) was the independent protective factor for hematoma enlargement. Conclusions Systolic blood pressure and NIHSS score were the independent risk factors for hematoma enlargement after spontaneous intracerebral hemorrhage, while low -density lipoprotein cholesterol was the independent protective factor for hematoma enlargement.
ABSTRACT
Objective To investigate the ability of decision making under risk condition in patients with Parkinson' s disease (PD),and to explore the neural relationship between basal ganglia and the decision-making ability.Method Twenty-five PD patients and 25 healthy controls (HC) were investigated by Game of Dice Test (GDT) with explicit probability.Results PD patients performed poorly in the entire task,selecting more risky options ( PD:10.88 ± 5.58 ; HC:5.72 ± 3.69 ; t =3.86,P ＜ 0.01 ),compared with healthy controls.In general,the final asset of PD group was negative while the result of HC group was always profitable and the difference was significant ( PD:- 3748.00 ± 3923.87 ; HC:684.00 ± 1764.62 ; t =-5.15,P ＜ 0.01 ).The most frequent choice made by PD patients was one number,which is the most risky one.Accordingly,the most frequent choice made by HC group was three numbers (one number:PD:6.48 ±5.81;HC:1.00 ± 1.44;t =4.58,P ＜0.01; three numbers:PD:2.64 ±2.14;HC:7.04 ±2.54;t =-6.62,P ＜ 0.01 ).The frequency of choosing the risky options was correlated with the rate of using negative feedback( r =-0.59,P =0.003 ),and the result of Stroop test( r =0.55,P =0.004).Conclusion Present study has shown that PD patients have significant impairments in decision-making under risk condition,and the impairments are correlated with executive function and negative feedback.