ABSTRACT
Objective To investigate the correlation between serum retinol-binding protein 4 (RBP4) level and stroke severity and short-term outcome in patients with acute ischemic stroke.Methods From January 2017 to December 2017,patients with acute ischemic stroke admitted to the Department of Neurobgy,the Third Affiliated Hospital of Anhui Medical University and who did not receive thrombolytic or endovascular treatment were enrolled retrospectively within 2 weeks of onset.The serum RBP4 levels were measured within 24 h of admission and the demographics and baseline clinical data of the patients were documented.On the day of admission,the National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of neurological deficit;≤8 was defined as mild stroke and ＞8 was defined as moderate to severe stroke.The modified Rankin scale was used to assess the short-term outcomes at the time of discharge or 14 days after onset;0 to 2 were defined as good outcomes,and ＞ 2 was defined as poor outcome.Results A total of 235 patients were enrolled,including 101 females (43％) and 134 males (57％);aged (66.8 ± 1.7) years (range 28-93 years).There were 200 mild strokes (85.1％) and 35 moderate to severe strokes (14.9％);171 (72.8％) had good outcomes and 64 (27.2％) had poor outcomes.Univariate analysis showed that the serum RBP4 level in the moderate to severe stroke group was significantly lower than that in the mild stroke group (29.28 ± 10.43 mg/L vs.36.88 ± 10.61 mg/L;t =3.920,P ＜ 0.001),and the RBP4 level in the poor outcome group was significantly lower than that in the good outcome group (32.03 ± 11.33 mg/L vs.37.14± 10.44 mg/L;t=3.264,P=0.001).Multivariate logistic regression analysis showed that the high serum RBP4 level was independently correlated with the milder stroke severity (odds ratio 0.917,95％ confidence interval 0.874-0.962;P ＜0.001) and short-term poor outcome (odds ratio 0.955,95％ confidence interval 0.927-0.983;P =0.002).Conclusion In patients with high serum RBP4 levels,acute ischemic stroke is less severe and better in short-term outcomes.
ABSTRACT
Objective To investigate the risk factors and MRA manifests in the patients with cortical wa-tershed infarcts(CWSI)or internal watershed infarcts(IWSI).Methods We collected the patients with acute wa-tershed infarcts in our hospital from January 2013 to April 2016.According to the Bogousslavsky classification stan-dard,the patients were divided into two groups:CWSI and IWSI. The two groups were compared in terms of risk factors and MRA manifests. Results We included 36 CWSI and 11 IWSI patients in the study.There were signifi-cant differences in smoke,diabetes mellitus,fasting blood glucose levels and carotid atherosclerotic plaque be-tween the two groups,and so it was with the stenosis of ICA,MCA,ACA,PCA,VA and BA:The stenosis of ICA in the CWSI group was more serious than in the IWSI group,but the stenosis of MCA,ACA,PCA,VA and BA in the IWSI group was more serious than in the CWSI group. Conclusions The pathogenesis of CWSI may be related to the formation of carotid atherosclerotic plaques,carotid stenosis and arterial artery embolism,or plaque shedding and micro emboli removal.The pathogenesis of IWSI may be related to the decrease of the perfusion pres-sure at the end of the intracranial artery.The ratio of IWSI to diabetes mellitus is higher than that of CWSI,suggest-ing that the damage of diabetes to intracranial arteriole is earlier than that of intracranial and extracranial arteries.