ABSTRACT
Objective:investigate the effect of serum uric acid (SUA) on long-term cerebrovascular mortality and recurrent stroke in patients with acute cerebral infarction.Methods:A total of 132 patients from the same center were enrolled in this study. The patients were divided into three groups according to the quartile level of SUA: group 1 (SUA < 442 μmol/L, n= 69) , group 2 (SUA 442-620 μmol/L, n=35) and group 3 (SUA > 620 μmol/L, n= 28). SUA, blood urea nitrogen, serum creatinine, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, triglyceride and hypersensitive c-reactive protein (hs-CRP) were measured in the three groups, the National Institutes of Health Stroke Scale (NIHSS) score was determined on the day of admission, and the patients were followed up until December 31, 2020. The differences of recurrent stroke and cerebrovascular mortality in the three groups were analyzed. Results:Sixty-nine patients were selected in group 1, 35 in group 2 and 28 in group 3. Patients in group 2 and group 3 were younger, and had higher hs-CRP levels, higher SUA levels, and higher rates of recurrent stroke and cerebrovascular mortality, and the differences were statistically significant (all P<0.05). Cerebrovascular mortality (log-rank χ2 =13.19, P=0.001) and recurrent stroke (log-rank χ2 =10.30, P=0.006) were significantly increased in group 3. The risk of recurrent stroke in group 3 was 3.55 times higher than that in group 1. Conclusions:The risks of long-term cerebrovascular mortality and recurrent stroke were significantly increased in patients of acute cerebral infarction with elevated serum uric acid.
ABSTRACT
Objective:To evaluate the clinical effect and safety of the thrombolysis-combined butyphthalide therapy on acute cerebral infarction.Methods:A total of 58 patients with acute cerebral infarction receiving thrombolytic therapy in Henan Provincial People's Hospital from June 2016 to August 2018 were randomly divided into the thrombolytic group(recombinant tissue type plasminogen activator i. e.rt-PA, n=29)and the group of butyphthalide plus rt-PA(n=29). Neurological function(National Institutes of Health Stroke Scale, NIHSS), daily living ability(Barthel index score)and the ultrasound-detected cerebral blood flow were compared between the two groups to evaluate the clinical efficacy and safety.Results:After the treatment, NIHSS score was significantly lower in the group of butyphthalide plus rt-PA than in the thrombolysis group(5.24±2.61 vs.8.15±2.55 points, P=0.015). The Barthel index was significantly higher in the group of butyphthalide plus rt-PA than in the thrombolysis group(75.32±4.42 vs.57.37±3.54 points, P=0.024). The cerebral blood supply was improved in both groups after treatment as compared with pre-treatment.After treatment, the peak flow velocity of middle cerebral artery was 78.34±4.82 cm/s and 67.16±3.37 cm/s( P=0.017)and the average flow velocity of the middle cerebral artery was(44.19±2.18)cm/s and(37.49±2.16)cm/s( P=0.029)in the group of butylphthalide plus rt-PA than in the thrombolysis group, respectively, which showed the blood supply of the middle cerebral artery was better in butyphthalide plus rt-PA therapy than in thrombolytic therapy.Clinical effective rate was 89.7%(26/29)in butyphthalide plus rt-PA group, which was better than that in the thrombolysis group(65.5%, 19/29)( χ2=4.851, P=0.029). During the treatment, 2 patients had mild gastrointestinal reactions in both groups, which were relieved after treatment of symptoms, and no serious adverse reaction occurred in other patients. Conclusions:The combined therapy of butyphthalide and thrombolysis can improve clinical efficacy rate on acute cerebral infarction, improve the cerebral hemodynamics, promote the recovery of neurological function, and improve the quality of life of patients.
ABSTRACT
Objective:To investigate the effect of hyperuricemia treatment on vascular endothelial function and blood pressure in patients with acute cerebral infarction.Methods:A total of 138 cases from the same center were enrolled in the study. 92 cases of acute cerebral infarction patients combined with hyperuricemia were selected. They were randomly divided into the experimental group (46 cases) and control group (46 cases). 46 cases of acute cerebral infarction patients with normal uric acid were selected in the same period. Patients in the experimental group received oral allopurinol for 3 months to treat hyperuricemia. Serum uric acid, blood lipid, and hs-CRP were tested before and after treatment in these populations. Blood pressure and body mass index (BMI) were also detected, and vascular endothelial function was evaluated using ultrasound non-invasive blood flow mediated vasodilation function (FMD). Comparison and statistical analysis were carried out in groups.Results:Uric acid [(479.7±49.0) μmol/L vs. (381.2±76.7) μmol/L]、hs-CRP[(8.1±6.7) mg/L vs. (5.1±4.6) mg/L]、systolic blood pressure [(124.7±26.3) mmHg vs. (97.4±13.5) mmHg] decreased significantly in the experimental group after 3 months of treatment with allopurinol ( P<0.05), and blood flow mediated vasodilation function [(7.6±3.5) vs. (11.2±3.9)]significantly increased ( P<0.05). The decrease of serum uric acid was positively correlated with the increase of FMD in the experimental group ( r=0.463, P<0.01). Multiple Regression analysis showed that serum uric acid was an independent predictor of FMD( β=-0.229, P=0.035). Conclusions:The treatment of hyperuricemia in patients with acute cerebral infarction can significantly improve the vascular endothelial function of patients, improve inflammation state and lower blood pressure. It is further confirmed that a higher uric acid level is related to worse endothelial function which may contribute to atherosclerosis.
ABSTRACT
Objective:To investigate the relationship of glycated hemoglobin(HbA1c)and brain natriuretic peptide(BNP)levels with clinical prognosis of acute myocardial infarction.Methods:A total of 108 patients with acute myocardial infarction combined with diabetes mellitus, who underwent percutaneous coronary intervention(PCI)from March 2016 to June 2017 in our hospital, were enrolled.According to the HbA1c level, patients were divided into three groups: Group A(HbA1c≤6.9%, n=36), Group B(7%≤HbA1c≤7.9%, n=31)and Group C(HbA1c≥8%, n=41). HbA1c and NT-proBNP levels, cardiac function classification at admission and discharge, the incidence of adverse cardiac events during hospitalization and left ventricular ejection fraction(LVEF)at admission, discharge and 3 months after discharge were analyzed.Results:Among the three groups, plasma NT-proBNP levels were higher in Group C than in Group B and Group A( P<0.05), and there was no significant difference between Group B and Group C( P<0.05). Furthermore, HbA1c levels were positively correlated with NT-proBNP levels in Group C( P<0.05). Cardiac function grading was better in Group A and Group B than in Group C at discharge.During hospitalization, the incidence of adverse cardiac events in Group C was 29.3%, which was higher than in Group A(8.3%)and Group B(9.7%)( P<0.05). LVEF levels were significantly improved in Group A and Group B at discharge and 3 months after discharge, compared with those at admission, while Group C had no significant improvement in LVEF levels and had lower LVEF than Group A and Group B( P<0.05). Conclusions:HbA1c and NT proBNP levels can be used as a joint monitoring indicator in patients with acute myocardial infarctions after PCI, to help prevent and reduce the incidence of complications and mortality in patients with acute myocardial infarction after PCI and improve clinical prognosis.
ABSTRACT
Objective To explore the role of clinical application of enteral nutrition sequential therapy in early enteral nutrition support by comparison with enteral nutrition non-sequential therapy in critically ill patients with cerebrovascular diseases.Methods A total of 62 patients were randomly (random number) divided into sequential group and conventional (non-sequential) grouThe comparisons of tolerance for enteral nutrition support,levels of prealbumin,the mechanically ventilated time and mortality rate in 28-day between two groups were carried out.Results The tolerance of sequential group was superior to that of conventional group (P＜0.05).The higher level of prealbumin and the shorter mechanical ventilation time were observed in sequential group compared with conventional group (P＜0.01).Compared with conventional group,the patients in sequential group had lower mortality rate in 28 days (P＜0.05).Conclusions Sequential therapy is beneficial to the implementation of early enteral nutrition support in patients with severe cerebrovascular disease,reducing the nutritional adverse events,and improves the prognosis.
ABSTRACT
Objective To evaluate the effect of atorvastatin on human carotid plaque by high resolution nuclear magnetic resonance imaging(MRI 3. 0T). Methods Forty patients with carotid artery plaque were treated with atorvastatin at the dose of 20 mg daily for one year. Changes of the artery plaques were observed by MRI,and the levels of blood lipoproteins and C reactive protein( hs-CRP)were detected. Results After the treatment with atorvastatin for 6 months and 1 year,the number and average thickness of plaques were reduced. One year after the treatment,average thickness of stable plaques dropped from (2. 41±0. 54)mm to(2. 17±0. 49)mm,and the size of the unstable plaques decreased from(2. 38±0. 89)mm to(2. 01± 0. 32)mm,with significant differences(P﹤0. 05). The levels of TC,TG,LDL-C and Hs-CRP were significantly decreased(P﹤0. 05)and the level of HDL-C was increased. Conclusion High resolution nuclear magnetic resonance( MRI3. 0T)can clearly display the components of the atherosclerotic plaque and the degree of artery stenosis. Atorvastatin exerts a significant effect on carotid plaque by promoting the regression of the carotid atherosclerosis plaque.
ABSTRACT
Objective To study the effects of ginsenoside on expression of inducible nitric oxide synthase and concentration of NO in THP-1 induced by amyloid beta(Aβ) in Alzheimer's disease. Methods The concentra- tion of nitric oxide was determined by Griess Reagent in supernatant of THP-1. The content of iNOS was measured by western blotting. Results The expression of iNOS of model group was significantly higher than those of control group. Compared with model group, the ginseng could reduce expression of iNOS and concentration of NO significant- ly in THP-1. Conclusion Ginsenoside can significantly inhibit the expression of iNOS, and reduce secretions of NO, so it may provide a novel therapy for AD.