ABSTRACT
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.
ABSTRACT
Objective:The changes both within lesions and normal-appearing white matter load on T2-weighted MRI in patients with ischemic leukoaraiosis(ILA) was investigated by diffusion tensor MRI(DTI) and the relation between the changes of DTI parameters and cognitive dysfunction was assessed.Methods: Thirty-four patiens with ischemic leukoaraiosis and 19 healthy volunteers underwent DTI,conventional MRI,and neuropsychological assessment. Results: In ILA group,on DTI,diffusity was increased within lesions and in normal-appearing white matter compared with the control group,FA was reduced.The changes of MD in the NAWM correlates with full scale intelligence quotient(IQ) and executive dysfunction,the changes of FA in the NAWM correlates with global cognitive impairment assessed by the MMSE. Conclusion: DTI can reveal pathological changes in normal-appearing white matter load on T2-weighted MRI in patients with ischemic leukoaraiosis,which correlates with cognitive dysfunctions.