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@#Objective To analyze the features of poststroke depression (PSD) between men and women after acute ischemic stroke in China. Methods A total of 1917 ischemic stroke patients were enrolled from the Prospective Cohort Study on Incidence and Outcome of Patients with Poststroke Depression in China. The incidence of PSD and the features were compared between male and female patients. The factors related with PSD of every gender were extracted with Logistic regression analysis. Results The incidence of PSD was higher in women than in men (32.9% vs. 26.6%, P<0.01). There was no difference in the stroke score between women and men (P>0.05). The score of Hamilton Depression Scale was higher in the women than in the men, and the features were similar. Logistic regression analysis indicated that the history of heart disease, history of mental disorders and stroke score related with PSD in women, while the age, history of mental disorders, smoking and stroke score in men. Conclusion The incidence and related factors of PSD 2 weeks after ischemic stroke are different between men and women.
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Objective To explore the risk factors and their prognostic value in Chinese female patients with ischemic stroke.Methods A total of 4 442 female patients with ischemic stroke were enrolled in the study from the Chinese National Stroke Registry System.According to the modified Rankin Scale (mRS) score,patients were divided into the group A (with good outcomes,mRS =0-2) and the group B (with bad outcomes,mRS =3-6),with the follow-up for 12 months.The risk factors were collected at month 3 and month 12,including age,family history,body mass index (BMI),hypertension,diabetes mellitus (DM),hyperlipidemia,atrial fibrillation (AF),coronary heart disease (CHD),smoking and moderate or heavy alcohol intake.The multivariate logistic regression was performed to determine the prognostic value of those risk factors.Results Patients in the group B were older than those in the group A [month 3:(71.3 ± 11.4) years oldvs (65.5±11.8) years old and month 12:(71.9±11.3) years old vs (65.1 ±11.6)years old,with both P ＜0.001].Patients in the group B were found to have higher ratio of BMI ＜25 kg/m2(66.3％ vs 62.0％,P =0.006;66.6％ vs 61.8％,P =0.002) and more likely to have the history of DM (27.0％ vs 23.3％,26.6％ vs 23.6％,respectively; both P ＜ 0.05),A F (18.0％ vs 6.2％,17.9％ vs 6.3％,respectively; both P ＜0.001) and CHD (21.4％ vs 14.4％,21.8％ vs 14.2％,respectively; both P ＜ 0.001) than those in the group A.The multivariate logistic regression analysis showed that women's age (OR =1.04,1.05,95％ CI 1.03-1.05,1.04-1.06,respectively),the histories of DM (both OR =1.35,95％ CI 1.15-1.58,respectively) and AF (OR =2.91,2.84,95％ CI 2.33-3.64,2.27-3.56,respectively) were significantly associated with the bad outcomes at month 3 and month 12.The history of CHD was associated with the bad outcomes at month 12 (OR =1.20,95％ CI 1.00-1.43),while the history of hyperlipidemia might improve the outcome at month 12 (OR =0.75,95％ CI 0.60-0.94).Conclusions The risk factors may have different prognostic value in female patients with ischemic stroke.The diagnosis and treatment for DM,AF and CHD may be helpful to improve the prognosis in Chinese female patients with ischemic stroke.
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Objective To explore the relation between plasm neurotransmitters (Glutamic acid,GAA; γ-aminobutyric acid,GABA; 5-hydroxytryptamine,5-HT; and noradrenaline,NE) and depression in acute hemorrhagic stroke.Methods Objectives were screened from consecutive hospitalized patients with acute stroke.Fasting blood samples were taken on the day next to hospital admission,and neurotransmitters were examined by the liquid chromatography-high resolution mass spectrometry (LC-HRMS).The fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-Ⅳ) was used to diagnose depression at two weeks after onset of stroke.The modified Ranking Scale (mRS) was followed up at 1 year.Pearson test was used to analyse the correlation between serum concentration of neurotransmitters and the Hamilton Depression scale-17items (HAMD-17) score.Logistic regression was used to analyse the relation of serum concentration of neurotransmitters and depression and outcome of stroke.Results One hundred and eightyone patients were included in this study.GABA significantly decreased [6.1 (5.0-8.2) μg/L vs 8.1 (6.3-14.7) μg/L,P ＜ 0.05] in patients with depression in hemorrhagic stroke,and there was no significant difference in GAA,5-HT,or NE.GABA concentration was negatively correlated with HAMD-17 score (r =-0.131,P ＜ 0.05) ; while concentration of serum GABA rose by 1 μg/L,risk of depression in acute phase of hemorrhagic stroke was reduced by 5.6％ (OR 0.944,95％ CI 0.893-0.997).While concentration of serum GAA rose by 1 μg/L,risk of worse outcome at 1 year was raised by 0.1％,although a statistic level was on marginal status (OR 1.001,95％ CI 1.000-1.002).Conclusions In patients with depression in the acute phase of hemorrhagic stroke,there was a significant reduction in plasm GABA concentration.GABA may have a protective effect on depression in acute phase of hemorrhagic stroke.Increased concentrations of serum GAA may increase the risk of worse outcomes at 1 year after stroke.
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ObjectiveTo investigate the clinical characteristics,3-month outcome and predictive factors in the very elderly patients with ischemic stroke.MethodsA total of 305 acute ischemic patients aged 65 years and over were enrolled in the study.They were divided into two subgroups by age:80 years old and over(n =78),65-79 years old(n =227).The clinical outcome was assessed by the modified Rankin Scale (mRS) on (90 ± 7 ) days after stroke,and categorized as good ( scoring 0-2 ) or poor( scoring 3-6) outcome.Results Significantly lower BMI [ ( 23.62 ± 4.92 ) kg/m2 vs ( 25.08 ± 3.69 ) kg/m2,P =0.005],lower frequency of dyslipidemia(56.41％ vs 71.13％,P =0.006) and alcohol intake (0％ vs 6.61％,P =0.043 )were found in the very elderly group.The rates of poor functional outcome in the ≥ 80years group and the 65-79 years old group were 56.41％ (44/76) and 41.40％ (94/224) respectively,with a P value of 0.015.Multivariate logistic regression analysis showed that higher National Institute of Health stroke scale (NItISS) total score (OR 1.48,95％ CI 1.19-1.83 ) and lower albumin level (OR 0.73,95 ％ CI 0.55 -0.95 ) were associated with poor outcome in ≥ 80 year old,whereas higher NIHSS total score ( OR 1.38,95％ CI 1.24-1.53) and complications during hospital stay ( OR 2.58,95％ CI 1.07-6.19 ) were predictive factors in the 65-79 years old group.ConclusionOur study suggests that NIHSS scores,albumin level and complications during hospitalization are useful predictive factors for the short-term poor functional outcome in the patients of ≥65 years old and ≥80 years old patients have a worse prognosis.
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The population of the very elderly is growing steeply with prolonged life expectancy.Age is an independent risk factor for stroke.Naturally,the very elderly become the high risky population.Hypertension is the most common and modifiable risk factor of stoke in the very elderly.Results of studies conducted during these 20 years have been reported to explore and investigate the relationship between stroke primary prevention and antihypertensive treatment,some of which are regarded as landmarks trials,providing essential evidences for blood pressure management in the very elderly.
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OBJECTIVE:To observe thc usefulness of Utilin S in treatment of chronic obstructive pulmonary disease(COP- D). METHODS: In a random control design, trial group was given Utilin S 1. 72ug im, qw. on the basis of conventional treat- ment. Control group was given conventional treatment alone. RESLLTS: The clinical effect. symptom and immune indices of trial group were all better then those of control group. CONCLUSION: Utilin S, as a immunostimulant. has a good accessory therapcutic effect on COPD.