ABSTRACT
Objective To investigate the predictive factors of short-term poor outcome in patients with cerebral venous sinus thrombosis (CVST).Methods The clinical data of 42 consecutive inpatients with CVST were analyzed retrospectively.The clinical outcomes were assessed with the modified Rankin scale (mRS) at discharge.The patients were divided into either a good outcome group (mRS 0 to 2) or a poor outcome group (mRS 3 to 6).The related factors,such as demographic,etiology,and clinical features were compared between the two groups,Multivariate logistic regression analysis was used to determine the independent predictive factors for short-term poor outcome in patients with CVST.Results A total of 42 patients with CVST were enrolled,29 of them (69.05％) had good outcome and 13 (30.95％) had poor outcome.The proportions of central nervous system infections (20.69％ vs.61.54％ ; x2 =6.740,P =0.009),cancer (6.90％ vs.38.46％ ;x2 =6.439,P =0.011),pregnancy,postpartum,oral contraceptives or hormone replacement therapy (6.90％ vs.38.46％ ; x2 =6.439,P =0.011),and high homocysteine hyperlipidemia (27.59％ vs.76.92％ ;x2 =8.922,P =0.003),as well as the baseline D-dimer levels (730 ± 240 ng/ml vs.1 060 ± 250 ng/ml; t =4.485,P =0.000) in patients of the good outcome group were significantly lower than those of the poor outcome group.There was significant difference in treatment modalities (x2 =11.274,P =0.004) with the poor outcome group.The proportions of patients in anticoagulants,thrombolysis and anticoagulants + thrombolysis were 13.79％,24.14％,and 62.07％,respectively,in the good outcome group,while those were 61.54％,23.08％,and 15.39％,respectively,in the poor outcome group.Multivariate logistic regression analysis showed that the baseline D-dimer level ＞990 ng/mL was an independent predictive factor for short-term poor outcome in patients with CVST (odds ratio [OR] 1.006,95％ confidence interval [CI] 1.002-1.011; P=0.005).Anticoagulants + thrombolytic therapy was an independent protective factor for short-term poor outcome in patients with CVST (OR 0.027,95％ CI 0.002-0.447; P=0.033).The ROC curve analysis showed that when the cutoff value of the baseline D-dimer was 990 ng/ml,the sensitivity and specificity of predicting short-term poor outcome of CVST were 76.9％ and 86.2％ respectively.Conclusions The level of baseline D-dimer ＞990 ng/ml is an independent predictive factor for short-term poor outcomes in patients with CVST.The effect of anticoagulants in combination with thrombolytic therapy is best in patients with CVST.
ABSTRACT
Objective To investigate the differences of risk factors for ischemic stroke between the Han and Uygur nationalities in Xinjiang China.Methods The data of demography,vascular risk factors,lifestyle as well as blood pressure,blood glucose and blood lipids on admission of 589 patients with stroke (Han 294 cases and Uygur 295 cases) in 5 hospitals from 2007 to 2009 in Xinjiang,China were collected.The exposure levels or the proportion of the risk factors for ischemic stroke between the 2 nationalities were compared.Results The proportions of smoking (18.0％ vs.11.5％,x2 =4.945,P =0.026) and alcohol consumption (37.8％ vs.21.5％,x2 =9.884,P =0.002) in the Han patients were significantly higher than those in the Uygur patients,while the body mass index in the Uygur patients with ischemic stroke was significantly higher than that in the Han patients with ischemic stroke (25.168 kg/m2 vs.24.443 kg/m2,t =2.515,P =0.012).Conclusions The onset of ischemic stroke of the Han people in Xinjiang China may be more associated with the exposure of smoking and alcohol consumption,while the Uighur people may be more associated with the high-fat and high energy intake caused obesity.