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Objectives To investigate the factors influencing long-term quality of life (QOL)of patients with first-episode ischemic stroke(IS)and partial side limb dysfunction.Methods 126 cases of the first ischemic stroke patients with partial side limb dysfunction admitted to hospital from November 2012 to July 2013 in Shanghai First People's Hospital were selected.General information of patients was collected and evaluated using NIH Stroke Scale(NIHSS)and Modified Rankin Scale(MRS).Following-up was conducted using NIHSS,MRS,stroke specific quality of life (SS-QOL) and Hamilton Depression Scale (HAMD) during 2-3 years after stroke Factors related to long-term QOL were screened by single factor analysis,then factors influencing QOL by multiple stepwise regression analysis.Results The average QOL score of patients with first IS partial side limb dysfunction was(181.5 ± 46.4)points scale.In each single scoring,the scale was(10.4±4.3)points in energy,(10.8±4.2)points in family roles,(21.8±6.2)points in language,(22.5 ±7.6) points in activity,(18.5±6.3)points in mood,(10.1±4.4)in personality,(19.2±5.9)points in self-care ability,(16.1 ± 7.0) points in social roles,(11.65 ± 3.31) points in thinking,(19.1 ± 6.6) points in upper limb function,(14.0 ± 2.0) points in visual acuity,(8.7 ± 4.1) points in work.The multiple regression analysis showed that the influencing factors of life quality included long-term NIHSS evaluation(β=-0.376,P＜0.01),HAMD evaluation(β=-0.375,P＜0.01),hypertension history(β=-0.178,P＜0.05).HAMD evaluation affected 9 fields of QOL,and NIHSS as long-term evaluation affected 6 fields of QOL.Conclusions Predictive factors for declined QOL of first-episode ischemic stroke patients with partial side limb dysfunction include higher NIHSS score,severer depression after long-term stroke and combined hypertension in the early stage.These indicate that recovering of body structure and function injury,control of hypertension,effective prevention and treatment of post-stroke depression maybe important measures for improving life quality of ischemic stroke patients with partial side limb dysfunction.
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Objective To investigate the head and neck CTA findings and cerebral CTPI in patients with transient ischemic attack (TIA),and their relationship with frequency of TIA,duration and CTA detected responsible vessels.Methods 180 TIA patients were selected as the research subjects,the GE Lightspeed 64 spiral CT perfusion CT scan and CTA examination were taken,and the differences in CTPI parameters measurement,head and neck artery disease of patients were analyzed.To observe the correlation between CTPI perfusion abnormalities in patients with TIA seizure frequency,duration and NIHSS score.The CTPI perfusion abnormalities and consistency of CTA display of responsible vessels were analyzed.Results The positive rate of CTPI examination was 75.56％,that of CTA examination was 81.11％.The positive rate of patients(NIHSS ≥4 points) with CTPI was 88.89％,which was higher than 66.67 ％ in patients (NIHSS ＜ 4 points) with CTPI (x2 =6.87,P ＜ 0.05).The positive rate of patients (seizures time ≥ 10min) with CTPI TIA was 71.43％,which was higher than 45.45 ％ of the patients (seizures time ＜ 10m in) with CTPI (x2 =7.23,P ＜ 0.05).The CTPI positive rate of patients with the TIA seizure frequency ≥ 2 times/d was 83.33％,which was higher than 61.67％ of patients with the seizure frequency ＜ 2 times/d(x2 =5.48,P ＜ 0.05).The CTPI positive and CTA responsibility vascular consistent proportion was 73.33 ％,which was significantly higher than 26.67％ of both inconsistent and negative (x2 =19.43,P ＜ 0.01).Conclusion The cerebral CTPI and head and neck CTA can response to TIA in patients with intracranial lesions accurately,consistency and clinical manifestations are very good,which have higher value in clinical application.
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Objective To investigate the risk factors of neuron-specific enolase (NSE) increasing in patients with cerebral ischemic stroke (CIS) by Logistic regression analysis,in order to provide the more theoretical basis for the prevention and treatment of the CIS.Methods A total of 210 patients with CIS from May 2007 to December 2011 was enrolled in this study.The neurological dysfunction was evaluated by U.S.National Institutes of Health Stroke Scale (NIHSS).The carotid artery intima-media thickness(IMT)was assessed by ultrasonography.The level of serum NSE was measured by ECLIA analysis.The patients were divided into low NSE group (NSE ≤12 μ g/L) and high NSE group (NSE ＞ 12 μ g/L).Results Low NSE group had 94 cases,and high NSE group had 116 cases.Univariate analysis showed that there was significant difference in NIHSS score,carotid artery IMT,hypertension,coronary heart disease,diabetes,white blood cell count,total cholesterol (TC),triacylglycerol (TG),low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) between low NSE group and high NSE group [(15.8 ± 3.4) scores vs.(21.6 ± 4.7) scores,(1.12 ± 0.31) mm vs.(1.68 ± 0.54) mm,29.8％(28/94) vs.58.6％(68/116),17.0％(16/94) vs.30.2％(35/116),13.8％(13/94) vs.27.6％(32/116),(6.68 ± 3.45) ×109/L vs.(10.08 ± 4.27) × 109/L,(4.67 ± 1.22) mmol/L vs.(5.01 ± 1.64) mmol/L,(1.26 ± 0.44) mmol/L vs.(1.74 ±0.61) mmol/L,(3.42 ± 1.14) mmol/L vs.(5.26 ± 1.64) mmol/L,(1.32 ±0.22) mmol/L vs.(1.01 ± 0.17) mmol/L](P ＜ 0.05).Logistic regression analysis showed that NIHSS score,carotid artery IMT,white blood cell count,LDL-C,hypertension and diabetes were the independent risk factors of NSE increasing in patients with CIS.Conclusions NIHSS score,carotid artery IMT,white blood cell count,LDL-C,hypertension,diabetes are the independent risk factors of NSE increasing in patients with CIS.Treatment on the related risk factors can be expected to reduce the incidence of CIS,relieve the condition of disease and improve the prognosis of CIS.
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Objective To investigate the effects of electro-acupuncture on muscular tension and motor function in the flaccid,paralytic limbs of stroke survivors.Methods Seventy-two stroke survivors with flaccid,paralytic limbs were divided randomly into a control group and an electro-acupuncture group.Both grourps received routine therapy and rehabilitation training,but the electro-acupuncture group was also treated with electro-acupuncture.Muscular tension and motor function in the flaccid,paralytic limbs in both groups were evaluated by modified Ashworth scale (MAS)and Fugl-Meyer scores before treatment and at the end of 4 weeks.Results After treatment,in 24 patients of the electro-acupuncture group and 10 patients of the control group muscular tension had increased 1-2 grades.The effectiveness rate(68.57%)in the electro-acupuncture group wag higher significantly than that(27.03%)in the control group(P＜0.01).Fugl-Meyer scores in the electro-acupuncture group were significantlv higher than those in the control group(P＜0.01).Conclusion Electro-acupuncture supplementing traditional rehabilitation improves muscle tension in flaccid,paralytic limbs and promotes the recovery of motor flunction after stroke.