ABSTRACT
Objective:To research the clinical effect of HeDanPian combined with edaravone in the treatment of acute cerebral in farction and the influence on serum levels of interferon-γ (IFN-γ),promote angiogenin Ⅱ (Ang-2),homocysteine (Hcy).Methods:102 cases of patients with acute cerebral infarction were selected and randomly divided into the control group and the experimental group,with 51 cases in each group.The control group was treated with edaravone,intravenous infusion of30mg edaravone,1 time in the morning and night;The experimental group was treated based on the control group treated with HeDanPian,oral HeDanPian 14.6 g,1 time in the early to middle.The curative effect,nerve function defect score (NIHSS),serum IFN-γ Ang-2,Hcy,propylene glycol (MDA),superoxide disproportionation alcohol (SOD),interleukin 6,10 (IL-6,IL-10),tumor necrosis factor-α(TNF-α) levels,incidence of adverse reactions were compared between two groups.Results:After treatment,the total effective rate,serum Ang-2,SOD,IL-10 levels of experimental group were higher than those of the control group (P＜0.05),the NIHSS,serum IFN-γ,Hcy,MDA,IL-6,TNF-α levels of experimental group were lower than those of the control group (P＜0.05).No significant difference was found in the incidence of adverse reactions was found between the two groups (P＞0.05).Conclusion:HeDanPian combined with edaravone was effective in the treatment of acute cerebral infarction,which could regulate the expression of serum IFN-γ,Ang-2 and Hcy,improve the oxidative stress and inflammation.
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Objective To investigate the correlation of large artery stenosis and early neurological deterioration (END) of middle cerebral artery infarction.Methods The patients with middle cerebral artery infarction were enrolled retrospectively.END was defined as that the National Institutes of Health Stroke Scale (NIHSS) scores increased ≥2 within 72 hours of admission compared with the baseline value.Middle cerebral artery and internal carotid artery were evaluated by using cerebral angiography.The degree of stenosis was divided into 4 grades:non-or mild (＜ 50％),moderate (50-70％),severe (71-99％) stenosis,and occlusion (100％).The clinical risk factors,degree of neurological deficits,size of lesion,and major arterial lesions were compared between the END group and the non-END group.Results A total of 256 patients with middle cerebral artery infarction were enrolled,and END occurred in 70 of them (27.34％).The age (P =0.045),infarct volume (P =0.045),baseline NIHSS score (P=0.007),and major arterial stenosis (P =0.038) of the END positive group were significantly higher or lager than those of the END negative group.Multivariate logistic regression analysis showed that the higher baseline NIHSS score (odds ratio [OR] 1.071,95％ confidence interval [CI] 1.004-1.142; P =0.037),infarction diameter ＞ 20 mm (OR 2.077,95％ CI 1.077-3.736; P =0.028),and severe stenosis of the major artery (OR 2.521,95％ CI 1.079-5.886; P=0.033) or occlusion (OR 3.074,95％ CI1.262-7.489; P=0.013) were the independent predictor of END.Conclusions Severe stenosis or occlusion of the major artery may be an independent predictor of END in patients with middle cerebral artery infarction.
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Objective Toinvestigatetherelatedriskfactorsofneurologicaldeterioration(ND)in patientswithacutecerebralinfarction.Methods Atotalof446patientswithacutecerebral infarction admitted to the Department of Neurology,Zhongda Hospital,Southeast University from January 2012 to December 2013 were analyzed retrospectively. ND was defined as the reevaluation of the National Institutes of Health Stroke Scale (NIHSS)scores at any time for the increased admission baseline score 2 (ND2)or 4 (ND4)within the first 72 hours. All subjects were divided into a ND2 group (n=107)and a non-ND2 group (n=339)or a ND4 group (n=62)and a non-ND4 group (n=384 ). The differences of general demography,vascular risk factors,imaging,and hematological dataamongthedifferentgroupswerecompared.Results Ofthe446patients,107cases(24.0%) were diagnosed as ND2 and 62 cases (13. 9%)were diagnosed as ND4. The result of univariate analysis showed that there were significant differences in the length of hospital stay,age,baseline NIHSS score,baseline systolic blood pressure on admission,guilty artery occlusion,and the levels of leukocyte,fasting glucose,and C-reactive protein between the ND2 patients and the non-ND2 patients (all P<0. 05). There were significant differences in sex,age,atrial fibrillation,baseline NIHSS score, baseline systolic blood pressure on admission,guilty artery occlusion,and the level of C-reactive protein between the ND4 patients and the non-ND4 patients (all P<0. 05). After adjustment for the confounding factors,the results of Logistic regression analysis showed that the baseline NIHSS score (OR,1.114, 95%CI 1. 0481-1.185,P=0. 001),C-reactive protein (OR,1. 014,95%CI 1. 004-1. 024,P=0. 004), and guilty artery occlusion (OR,2. 303,95%CI 1. 152-4. 606,P=0. 018)were independently correlated with ND2;while the age (OR,1. 040,95%CI 1. 011-1. 070,P=0. 006),systolic blood pressure (OR, 1.015,95%CI 1. 003-1. 027,P=0. 018),C-reactive protein (OR,1. 016,95%CI 1. 005-1. 026,P=0.003),and guilty artery occlusion (OR,2. 845,95%CI 1. 291-2. 269,P =0. 009)were independently correlatedwithND4.Conclusion TheearlyonsetofNDinpatientswithacutecerebralinfarctionare closely associated with age,stroke severity,baseline systolic blood pressure,C-reactive protein,and occlusion of guilty artery. In the clinical diagnosis and treatment,detecting the above indicators timely may contribute to identify the patients with acute cerebral infarction and early progressive deterioration.