ABSTRACT
Based on the recently proposed Chinese ischemic stroke subclassification (CISS) system, intracranial branch atheromatous disease (BAD) is divided into large artery atherosclerosis (LAA) and penetrating artery disease (PAD). In the current retrospective analysis, we compared the general characteristics of BAD-LAA with BAD-PAD, BAD-LAA with non-BAD-LAA and BAD-PAD with non-BAD-PAD. The study included a total of 80 cases, including 45 cases of BAD and 35 cases of non-BAD. Subjects were classified using CISS system: BAD-LAA, BAD-PAD, non-BAD-LAA and non-BAD-PAD. In addition to analysis of general characteristics, the correlation between the factors and the two subtypes of BAD was evaluated. The number of cases included in the analysis was: 32 cases of BAD-LAA, 13 cases of BAD-PAD, 21 cases of non-BAD-LAA, and 14 cases of non-BAD-PAD. Diabetes mellitus affected more non-BAD-LAA patients than BAD-LAA patients (P=0.035). In comparison with non-BAD-PAD, patients with BAD-PAD were younger (P=0.040), had higher initial NIHSS score (P<0.001) and morbidity of ischemic heart disease (P=0.033). Within patients with BAD, the PAD subtype was associated with smoking (OR=0.043; P=0.011), higher low-density lipoprotein (OR=5.339; P=0.029), ischemic heart disease (OR=9.383; P=0.047) and diabetes mellitus (OR=12.59; P=0.020). It was concluded that large artery atherosclerosis was the primary mechanism of BAD. The general characteristics showed no significant differences between the CISS subtypes of LAA and PAD within BAD, as well as between the BAD and non-BAD within LAA subtype. Several differences between PAD subtypes of BAD and non-BAD were revealed.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Brain Ischemia , Pathology , China , Stroke , PathologyABSTRACT
Objective To investigate the relationship of the serum bilirubin level with acute ischemic stroke (AIS), and Chinese isch-emic stroke subclassification (CISS), stroke severity and short-term outcome of AIS patients. Methods 616 patients with AIS as well as 664 patients without stroke matched with gender and age were compared and analyzed with the non-conditional Logistic regression. The AIS pa-tients were divided based on the CISS, and their bilirubin levels were compared. The AIS patients were divided into high bilirubin group and normal bilirubin group, their scores of the National Institute of Health Stroke Scale (NIHSS) as admission and discharge, and neural func-tion improvement rate were compared. Results The levels of total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) were higher in the AIS group than in the control group (P0.05). The NIHSS score was higher in the high bilirubin group than in the normal bilirubin group as admission (P0.05), nor the rate of neural function improvement (P>0.05). Conclusion The serum bilirubin level elevated and correlated with the severity in the AIS patients, which might be the risk of pathogenesis and AIS. The bilirubin was not various with the CISS, and might be less involved in the short-term outcome of AIS.
ABSTRACT
By analyzing the clinical data of 216 cases of acute cerebral infarction (ACI) from 2012 January to 2013 June retrospectively,we found that the serum levels of high sensitive C-reactive protein (hs-CRP) in patients were significantly higher than those in 186 controls (P ＜0.01).The degree of neural function defect in ACI patients was assessed by the National Institutes of Health Stroke Scale (NIHSS) score.The hs-CRP level of the patients with NIHSS score ＞ 8 were higher than that in those with NIHSS score ≤8 (P ＜ 0.05).The hs-CRP level of patients of large artery atherosclerosis were (6.32 ± 4.12) mg/L and the positive rate of hs-CRP was 85.7％ (84/98).All were respectively higher than those in patients of penetrating artery disease [(1.97 ±0.86) mg/L,7/71],cardiogenic stroke [(3.70 ± 2.76) mg/L,14/24],undetermined etiology [(3.43 ± 3.52) mg/L,5/11] and other etiologies [(3.41 ± 3.25) mg/L,5/12] (all P ＜ 0.05).Logistic regression analysis was performed for the risk factors of ACI.The correlative factors of ACI included hypertension,diabetes mellitus,atrial fibrillation,smoking,total cholesterol,homocysteine and high sensitive C-reactive protein (OR =1.56,1.19,1.23,1.17,3.08,1.34,1.25,all P ＜ 0.01).The serum levels of hs-CRP increased significantly in ACI patients and were correlated with the degree of neural function defect.
ABSTRACT
Objective To investigate the safety and efficacy of intravenous thrombolytic therapy with recombinant tissue plasminogen activator(rtPA)in patients with isolated penetrating artery territory infarct (IPAI).Methods Data of retrospectively collected clinical,laboratory,and radiological from 75 consecutive patients with acute ischemic stroke treated with intravenous rtPA therapy from June 2009 to April 2011.Etiological classification was carried out according to the Chinese Ischemic Stroke Classification of Subgroups(CISS).The rates of hemorrhagic transformation(HT)and clinical outcomes of patients were compared between IPAI group and non-IPAI group.Results All 75 patients with mean age of 67.4years and 25(33.3％)fenale,were treated with intravenous rtPA.Before treatment,their average score of the National Institutes of Health Stroke Scale(NIHSS)was 12.3 ± 6.4,and mean length of time from onset to treatment was 239.6 ±97.5 minutes.After thrombolytic therapy,the radiological HT was found in 24 patients(32％).Symptomatic intracraneal hemorrhage(ICH)occurred in 4 patients(5.3％).Of 22 (29.3％)patients with IPAI,only one experienced HT.Logistic regression analysis suggested that IPAI wasan individualized predictor used alone for determining the low risk of HT.In the patients with IPAI,82％ of them had an individual clinical outcome(mRS ＜ 2)one month after onset,and the neurological outcomes were better in patients with IPAI than those in patients with non-IPAI(P ＜ 0.01).Conclusions The risk of hemorrhagic complication was low and the clinical outcome was good in patients with isolated penetrating artery territory infarct after intravenous thrombolytic therapy with rtPA.Imaging diagnosis of IPAI might facilitate the treatment with rtPA in this cohort of patients.