ABSTRACT
Objective:To analyze the risk factors for early neurological deterioration(END)in elderly patients with acute ischemic stroke(AIS)after intravenous thrombolysis.Methods:Clinical data of 118 patients with AIS who had received thrombolysis were collected retrospectively.According to the occurrence of END, cases were divided into the END group(n=28)and the non-END group(n=90). Univariate analysis was used to compare general characteristics, clinical data, laboratory test results, TOAST classification, infarct location, and degree of culprit vessel stenosis between the two groups.Multivariate Logistic regression analysis was used to analyze the related factors for END.Results:Univariate analysis showed that the proportion of patients with diabetes mellitus and previous cerebral infarction was higher in the END group than in the non-END group( χ2=4.000 and 8.056, P=0.046 and 0.005). There were significant differences in National Institutes of Health Stroke Scale(NIHSS)score, time from onset to thrombolysis, thrombolysis time, swallowing dysfunction, albumin, leukocyte count, neutrophil count, lymphocyte count, glycosylated hemoglobin(HbA1c), creatinine, total cholesterol(TC), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C)and lipoprotein(a)levels between the two groups(all P<0.05). There were also significant differences between the two groups in TOAST classification, infarct location and degree of culprit vessel stenosis( χ2=13.109 and 9.509, Z=2.912, P=0.004, 0.023 and 0.004). Multivariate Logistic regression analysis showed that NIHSS score, HbA1c, cardiogenic stroke, degree of culprit vessel stenosis and leukocyte count on admission were independent risk factors for END( OR=1.122, 2.131, 1.965, 1.876 and 1.563, P=0.036, 0.024, 0.028, 0.030 and 0.041). Conclusions:NIHSS score, HbA1c, cardiogenic stroke, degree of culprit vascular stenosis and leukocyte count on admission are independent risk factors for END, which should be closely monitored and managed with well formulated preventive measures in order to improve the prognosis of AIS patients.
ABSTRACT
Objective To discuss the correlation of apolipoprotein E (ApoE) gene polymorphism with cerebral infarction (CI)and intracerebral hemorrhage (ICH) among Tibetan nationality with cerebrovascular diseases in Qinghai Province, seek the differences in each allele of ApoE in Tibetan nationality. Methods The data from a total of 94 patients with cerebrovascular diseases was collected from the people's hospital of qinghai province, the people's hospital of guoluo prefecture , and the people's hospital of yushu prefecture as the cerebrovascular disease group, including 48 cases of cerebral infarction. There were 46 cases of cerebral hemorrhage. A total of 96 healthy Tibetan subjects were selected as the control group. DNA was extracted from all subjects. Real－time PCR was used to detect ApoE. The correlation between ApoE genotype and cerebral infarction and cerebral hemorrhage was analyzed. Results E2/E3 gene was common in Tibetan nationality with cerebrovascular diseases. E2/E3 genotype accounted for 50% in cerebral infarction group. E2/E3 (65.2%) was the most common in intracerebral hemorrhage group. E2/E4 (64.6%) was the most common in the control group. There was a statistically significant difference between the two groups (P＜0.01). In the Tibetan population, ε3 allele genome (48.0%) was the most common in cerebral infarction group and ε2(43.5%) were the most common alleles in intracerebral hemorrhage group. In the normal control group, ε4 (49.0%) was the most common allele. Conclusion E2/E3 genotype may be related to cerebrovascular diseases. ε3 allele may be the susceptible factor of cerebral infarction wherase ε4 may be the protective factor of cerebrovascular diseases in Tibetan population.