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Objective@#To investigate the value of combination of A2DS2 score, procalcitonin (PCT) and C-reactive protein (CRP) predicting stroke-associated pneumonia (SAP) in patients with acute ischemic stroke.@*Methods@#Patients with acute ischemic stroke admitted to the Department of Neurology, Suqian People's Hospital of Nanjing Drum Tower Hospital Group from March 2015 to March 2019 were enrolled retrospectively. Multivariate logistic regression analysis was used to determine the independent correlation of A2DS2 scores as well as PCT and CRP levels with SAP. Receiver operating characteristic (ROC) curves were used to assess the individual and combined predictive values of A2DS2 scores, PCT and CRP levels for SAP.@*Results@#A total of 332 patients with acute ischemic stroke were enrolled, and 58 of them developed SAP (17.5%). After adjusting for age, smoking, and hyperlipidemia, the A2DS2 score (odds ratio [OR] 1.613, 95% confidence interval [CI] 1.092-2.389), PCT (OR 8.047, 95% CI 3.012-16.138) and CRP (OR 1.409, 95% CI 1.064-2.672) were the independent predictors of SAP occurrence. ROC curve analysis showed that the area under the curve of A2DS2 score, PCT and CRP alone, and the combination of the three for predicting SAP were 0.811, 0.825, 0.804 and 0.910, respectively. When the three are jointly used to predict SAP, the area under the curve is significantly higher than the individual prediction (all P<0.001).@*Conclusions@#The combination of A2DS2 score, PCT and CRP can improve the ability to predict SAP.
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Objective To investigate the value of combination of A2DS2 score,procalcitonin(PCT) and C-reactive protein (CRP) predicting stroke-associated pneumonia (SAP) in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke admitted to the Department of Neurology,Suqian People's Hospital of Nanjing Drum Tower Hospital Group from March 2015 to March 2019 were enrolled retrospectively.Multivariate logistic regression analysis was used to determine the independent correlation of A2DS2 scores as well as PCT and CRP levels with SAP.Receiver operating characteristic (ROC) curves were used to assess the individual and combined predictive values of A2DS2 scores,PCT and CRP levels for SAP.Results A total of 332 patients with acute ischemic stroke were enrolled,and 58 of them developed SAP (17.5％).After adjusting for age,smoking,and hyperlipidemia,the A2DS2 score (odds ratio [OR] 1.613,95％ confidence interval [CI] 1.092-2.389),PCT (OR 8.047,95％ CI 3.012-16.138) and CRP (OR 1.409,95％ CI 1.064-2.672) were the independent predictors of SAP occurrence.ROC curve analysis showed that the area under the curve of A2DS2 score,PCT and CRP alone,and the combination of the three for predicting SAP were 0.811,0.825,0.804 and 0.910,respectively.When the three are jointly used to predict SAP,the area under the curve is significantly higher than the individual prediction (all P ＜ 0.001).Conclusions The combination of A2DS2 score,PCT and CRP can improve the ability to predict SAP.
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Objective To investigate the predictive value of serum glycated hemoglobin A1c (HbA1c)level and early neurological deterioration (END)in patients with acute cerebral infarction. Methods From June 2014 to January 2016,the consecutive patients with acute ischemic stroke (interval time from onset to admission < 3 days)admitted to the Department of Neurology,Suqian People′s Hospital were enrolled retrospectively. The neurological deficits of all patients were evaluated on the day of admission with the National Institutes of Health Stroke Scale (NIHSS). The symptoms of neurological deficits in patients were evaluated repeatedly for all patients within 7 days after admission. Any score increased ≥2 compared with before admission was defined as END. The 226 patients met the inclusion and exclusion criteria were enrolled,and they were divided into either an END group (n = 50,22. 1%)or a non-END group (n = 176,77. 9%)according to whether END occurred after acute cerebral infarction. Univariate analysis was used to analyze the differences between the 2 groups. Multivariable Logistic regression analysis was used to analyze the correlation between the HbA1c level and END. Results Compared with the non-END group,there were significant differences in the age,prevalence of diabetes,NIHSS score,hypersensitive C-reactive protein level,rate of ASPECT score 0-7,and serum HbAlc level in the patients of the END group (all P < 0. 05). The results of logistic regression analysis showed that the elevated hypersensitive C-reaction protein and serum HbA1c levels were the independent risk factors for END of acute cerebral infarction (OR,1. 048 and 1. 809 respectively,95% CI 1. 008 -1. 089 and 1. 429 -2. 292 respectively;P = 0. 018 and 0. 002 respectively). Conclusion The increased serum HbA1c level is an independent risk factor for END of acute cerebral infarction. It has certain predictive value for END.
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Objective To study the influence of applied times of Batroxobin on neuroprotective effects in cerebral ischemic-reperfusion(IR) injury gerbils.Methods 45 gerbils were randomly divided into five groups:normal group;cerebral IR injury model group(IR group);three times group;five times group;seven times group.The later three groups were administered Batroxobin 8 U/kg by abdominal injection q.o.d with certain times respectively.The normal group and IR group were not given drug but isometric physiological saline.Flow cytometer was used to measure apoptotic neurons of the hippocampal CA1,meanwhile electronic microscope was used to detect the ultrastrctural change of the hippocampal CA1 region.Result The quantity of apoptotic neurons in the every Batroxobin groups were significantly less than those in the IR groups(all P0.05).The ultrastrctural changes in five times group were lighter than those in three times group,but no significant difference was found between five times group and seven times group.Conclusion Three times,five times and seven times of Batroxobin can reduce the number of apoptotic neurons after IR injury.However,applied five times and seven times of Batroxobin has stronger neuroprotective effect than three times.