ABSTRACT
Objective:To investigate the risk factors for different types of single subcortical infarction (SSI) in middle cerebral artery territory and the risk factors for early neurologic deterioration (END).Methods:Patients with SSI in middle cerebral artery territory admitted to the Department of Neurology, People's Hospital Affiliated to Jiangsu University from January 2020 to April 2021 were enrolled retrospectively. According to the distribution of infarction, the patients were divided into proximal SSI (pSSI) and distal SSI (dSSI). The demographics, vascular risk factors and baseline clinical data were collected. END was defined as new signs and/or symptoms of neurological deficit or aggravation of any neurological deficit within 2 weeks after onset. Multivariate logistic regression analysis was used to determine the independent risk factors for pSSI and END. Results:Seventy-six patients with acute SSI in the middle cerebral artery territory were included, 41 patients (53.9%) in the pSSI group, 35 (46.1%) in the dSSI group; 13 (17.1%) in the END group, and 63 (82.9%) in the non-END group. There were no significant differences in age, gender, vascular risk factors and baseline National Institutes of Health Stroke Scale score between the pSSI group and the dSSI group. The total cholesterol, fasting blood glucose levels and the ratio of pSSI in the END group were significantly higher than those in the non-END group ( P<0.05), while the high-density lipoprotein cholesterol level was significantly lower than that of the non-END group ( P<0.05). Multivariate logistic regression analysis showed that pSSI was an independent risk factor for the occurrence of END in patients with SSI (odds ratio 6.75, 95% confidence interval 1.26-36.23; P=0.026). Conclusion:There was no significant difference in risk factors between pSSI and dSSI, but patients with pSSI were more prone to END.
ABSTRACT
Objective To investigate the impacts of c.388A ＞ G polymorphism of the solute carrier organic anion transporter 1B1 (SLCO1B1) gene on lipid-lowering and anti-atherosclerosis effects of atorvastatin in Chinese patients with ischemic stroke.Methods The patients with ischemic stroke whose baseline low-density lipoprotein cholesterol (LDL-C) ＞ 1.8 mmol/L were enrolled prospectively.They received atorvastatin (20 mg/d) for 12 months.The lipid and bilateral carotid intima-media thickness (CIMT) were measured respectively before and after treatment.The CIMT differences between SLCO1B1 c.388A＞G genotype groups were compared.Results A total of 71 patients with ischemic stroke were enrolled,including 5 AA genotype,31 AG genotype,and 35 GG genotype.The A allele frequency was 28.9％ and the G allele frequency was 71.1％.After treatment,the total cholesterol (TC),triglyceride (TG),and LDL-C in all patients were significantly lower than those before treatment,and high-density lipoprotein cholesterol (HDL-C) was significantly increase (all P＜0.001),but CIMT did not have significant change (P=0.475).The proportion of patients whose LDL-C ＜ 1.8 mmol/L or LDL-C decreased ≥50％ in the GG genotype group was significantly higher than the AG + AA genotypes group (74.29％ vs.44.44％;x2 =6.540,P =0.011).Conclusions SLCO1B1 gene c.388A ＞ G polymorphism could influence the lipidlowering effect of atorvastatin,lipid-lowering effect in the GG genotype group was better than that in the AG+ AA genotype group.SLCO1B1 gene c.388A ＞ G polymorphism did not have effect on the antiatherosclerosis effect of atorvastatin,but it might be associated with too short follow-up time.