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Objective:To explore the related risk factors of stress hyperglycemia in patients with acute cerebral infarction and the effect of stress hyperglycemia on short-term cognitive function and prognosis of acute cerebral infarction.Methods:A prospective study was used to select non-diabetic acute cerebral infarction patients who were hospitalized in Department of Neurology, North China University of Science and Technology Affiliated Hospital from June 2016 to November 2019 for observation.According to the increase in blood sugar, the study subjects were divided into stress hyperglycemia group (107 cases) and normal blood sugar group (202 cases), record two groups of general information.After single-factor and multi-factor analysis, independent risk factors for stress hyperglycemia were screened.The degree of neurologic impairment and cognitive function were evaluated on admission and 30 days after onset of the disease in the two groups.The incidence of complications within 30 days after onset of the disease was recorded, and the outcome evaluation of 30 days after onset was completed.The incidence of adverse prognosis was compared between the two groups.Results:The incidence of stress hyperglycemia was 34.6%.By univariate analysis, the proportion of hypertension history, smoking history and multifocal infarction in stress hyperglycemia group was higher than that in normal blood glucose group (all P<0.05), and age, body mass index (BMI), national institute of health stroke scale(NIHSS) score, admission systolic blood pressure, total cholesterol, low density lipoprotein cholesterol and hypersensitive C-reactive protein (hs-CRP) in the blood glucose group were higher than those in the normal blood glucose group (all P<0.05). Multivariate logistic regression analysis showed that age, admission systolic blood pressure, BMI, NIHSS score and multifocal infarction were independent risk factors of stress hyperglycemia in patients with non-diabetic acute cerebral infarction (all P<0.05); the incidence of cognitive impairment in stress hyperglycemia group was higher than that in normal blood glucose group (21.8% vs.12.7%; χ 2=4.155, P=0.042), and the 30-day MOCA score was lower than that of the normal blood glucose group.According to multivariate Logistic regression analysis, stress hyperglycemia was independently associated with cognitive impairment in the 30 days after acute cerebral infarction( OR=1.788, 95% CI: 1.127-2.836, P=0.014). The results showed that the incidence of poor prognosis in stress hyperglycemia group was significantly higher than that in normal blood glucose group ( P<0.05); multivariate logistic regression analysis showed that stress hyperglycemia was independent of other factors related to disease outcome, and closely related to poor prognosis ( OR=1.824, 95% CI1.410-2.664, P=0.003). In addition, disease progression ( OR=2.208, 95% CI1.542-3.104, P<0.001) and severity of admission ( OR=2.340, 95% CI1.670-3.279, P<0.001) were also independent risk factors for poor prognosis. Conclusion:The occurrence of stress hyperglycemia after acute cerebral infarction in non-diabetic patients is the result of multiple factors.It is an independent influencing factor of poor prognosis, and can be used as one of the important reference indicators to predict the disease condition.
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Objective To study the risk factors and outcome of symptomatic BAAS.Methods Eighty symptomatic BAAS patients served as a BAAS group and 80 symptomatic anterior circulation stroke (ACS) patients served as a ACS group in this study.The risk factors for symptomatic BAAS were compared.The symptomatic BAAS patients were further divided into mild-moderate stenosis group (n =43) and severe stenosis group (n=37),progressive stenosis group (n =34) and non-gressive group (n=46),survival group (n=42) and death group (n=38) respectively.The relationship between risk factors and outcome of symptomatic BAAS was analyzed.Results The rate of male patients and the incidence of hypertention were significantly higher in BAAS group than in ACS group (75.0％ vs 57.5％,80.0％ vs 66.3％,P＜0.01).The history of ischemic stroke and smoking was related with the severity of BAAS (P＜0.05).Premonitory symptoms were re lated with the progression of BAAS (P＜0.01).Pulmonary infection and tracheal intubation or tracheotomy were related with the outcome of BAAS (P＜0.01).Conclusion Male gender,hypertension,and history of ischemic stroke and smoking are the independent risk factors for symptomatic BAAS which is less likely to progress in patients with premonitory symptoms.Pulmonary infection and tracheal intubation or tracheotomy are the independent risk factors.
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<p><b>BACKGROUND</b>Many studies have suggested that C-reactive protein (CRP) and blood lipids are associated with hypertension and cardiovascular disease (CVD). However, few studies discussed the combined action of CRP and blood lipids on the risk of hypertension and prehypertension. This study aimed to investigate the combined action of CRP and lipid profiles on the risk of hypertension and prehypertension in Mongolian adults from Inner Mongolia, China.</p><p><b>METHODS</b>The systolic and diastolic blood pressure, height, weight and waist circumference were measured and factors such as smoking, alcohol intake, family history of hypertension, etc., were investigated and CRP, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) were tested for 2 534 Mongolian adults aged ≥ 20 years. The subjects were divided into four subgroups, namely CRP <median and LDL-C (TG) <median subgroup, CRP <median and LDL-C (TG) >median subgroup, CRP >median and LDL-C (TG) <median subgroup and CRP >median and LDL-C (TG) >median subgroup. The ORs (95% CIs) of hypertension and prehypertension for the subgroups were calculated by univariate and multivariate analysis.</p><p><b>RESULTS</b>The multivariate adjusted ORs (95%CIs) of hypertension/prehypertension were 1.389 (0.979-1.970)/1.151(0.865-1.531), 1.666 (1.159-2.394)/1.431 (1.060-1.930), 1.756 (1.242-2.484)/ 1.770 (1.321-2.372), for CRP <median and LDL-C >median subgroup, CRP >median and LDL-C <median subgroup, and CRP >median and LDL-C >median subgroup, respectively, compared with CRP <median and LDL-C <median subgroup. Similarly, the multivariate adjusted ORs (95% CIs) of hypertension/prehypertension were 2.032 (1.394-2.963)/1.442 (1.047-1.988), 1.412 (0.960-2.079)/1.596 (1.166-2.184), and 2.197 (1.595-3.027)/1.730 (1.321-2.266) for CRP <median and TG >median subgroup, CRP >median and TG <median subgroup, and CRP >median and TG >median subgroup, respectively, compared with CRP <median and TG <median subgroup. The risks of hypertension and prehypertension were the highest in the CRP >median and LDL-C (TG) >median subgroup among the four subgroups.</p><p><b>CONCLUSIONS</b>Subjects with both CRP >median and LDL-C (TG) >median had highest risks of hypertension and prehypertension among all subjects. This study appeared to indicate that the combined action of elevated CRP and elevated LDL-C (TG) further increase the risks of hypertension and prehypertension among Mongolian population.</p>
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Adult , Female , Humans , Male , Middle Aged , Body Height , Physiology , Body Weight , Physiology , C-Reactive Protein , Metabolism , China , Cross-Sectional Studies , Hypertension , Blood , Epidemiology , Metabolism , Lipids , Blood , Multivariate Analysis , Waist Circumference , PhysiologyABSTRACT
Objective To study the effect the edaravone on the expressions of ICAM-1,TNF-α after focal cerebral ischemia reperfusion in male rats.Methods 45 male SD rats were selected and randomly assigned into 3 groups:sham operation group(SO),ischemia reperfusion group(I/R),and edaravone treatment group(ED),each group had 15 rats.The expression of ICAM-1,TNF-α were checked by immunohistochemistry.All data in the groups were analyzed with t test.Results The expression of ICAM-1 and TNF-α in the I/R group and ED group were higher than the SO group(t=21.919,27.758,26.576,17.395,32.821,43.021,14.195,31.828,21.201,10.195,25.768,17.900,all P＜0.05)at reperfusion 3 hours,6 hours,and 12 hours.The expression of ICAM-1 and TNF-α in the I/R group were higher than the ED group(t=9.623,13.845,7.201,11.313,all P＜0.05)at reperfusion 3 hours and 6 hours.Conclusion Edaravone may exert the neuroprotective effect against the cerebral ischemia in rats by decreasing the expression of ICAM-1 and inhibiting the activation of TNF-α.This process could inhibit free radical generation.
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Objective To study the level changes of matrix metalloproteinase-9 (MMP-9)and its clinical significance in patients with progressive ischemic stroke(PIS).Methods 136 cases of acute ischemic stroke including 46 cases of PIS and 90 cases of non-PIS,were studied.56 healthy subjects were selected into control group.MMP-9 level was measured by ELISA at 2,7 and 14 day after admission.The neurologic dysfunction score was observed.Results The MMP-9 level was ( 249.43 ± 63.76)μg/L,( 271.50±72.08 )μg/L,and (183.20 ±66.69)μg/L in PIS group,while it was (158.81±49.18 )μg/L,( 188.67±57.96 )μg/L,and ( 93.86 ±22.16)μg/L in non PIS group and was (88.60±15.93 )μg/L in control group at 2,7 and 14 days of admission.The MMP-9 level of PIS group at 2,7 and 14 day and the level in non PIS group at 2 and 7 day were higher than that of control group(P＜0.01 ).The MMP-9 level of PIS group was higher than that of different phrase of PIS group (P＜0.01 ).Linear X2 showed that the increase of MMP-9 level would increase the risk of ischemic stroke progression( X2=38.96,P＜0.01 ).Conclusion The remarkable increase of MMP-9 in patients with progressive ischemic stroke may be the indepent risk factor of the progression of ischemic stroke.