ABSTRACT
OBJECTIVE：To investigate the risk factors for the recurrence of ischemic stroke after secondary prevention ，and to observe the effect of glutathione on 4-HNE. METHODS ：Totally 97 patients with ischemic stroke relapse within one year were treated from Oct. 2017 to Oct. 2019 in 3 hospitals as the Second Affiliated Hospital of Shandong First Medical University due to cerebral thrombosis or cerebral embolism as observation group ，and 97 non-recurrence patients in the same period were paired as control group. The patients in the observation group were randomly divided into conventional treatment group （49 cases）and drug intervention group （48 cases）. The patients in conventional treatment group received routine treatment such as cerebral blood flow recanalization， improving circulation ， controlling blood pressure ， maintaining blood glucose ， treating hyperlipidemia and arrhythmia during hospitalization. Drug intervention group was additionally given Glutathione for injection 1.8 g intragastrically ， once a day ，on the basis of conventional treatment group. 4-HNE concentrations in plasma were determined at admission and 14 days after treatment ，the genetic type of ALDH2 and type of TAST were determined at admission. Multiple liner regression was used to analyze the factors associated with 4-HNE increasing ； conditional Logistic analysis was used to identify independent risk factors resulting to ischem ic stroke recurrence after secondary prevention. RESULTS ：The plasma concentration of 4-HNE at admission and the percentage of arte ry atherosclerosis patients in observation group were significantly higher than control group（P＜0.05）. The distribution of each ALDH2 genotype in 2 groups complied with Hardy-Weinberg genetic equilibrium （P＞ 0.05）. The proportion of patients carrying ALDH2*2 allele in observation group （50.50％）was significantly higher than control group（36.08％）（P＜0.05）. ALDH2*2 allele [ B＝2.33，95％CI（1.35，5.50），P＝0.03] and artery atherosclerosis [ B＝1.90，95％CI （1.29，3.74），P＝0.04] were significantly associated with the elevation of plasma concentration of 4-HNE；artery atherosclerosis [OR＝ 2.93，95％CI（1.84，4.67），P＜0.01]，stroke family history [OR ＝1.50，95％CI（1.18，1.90），P＝0.04]，elevated plasma concentration of 4-HNE [OR ＝1.34，95％CI（1.11，1.62），P＝0.04] were regarded as independent risk factors associating with ischemic stroke recurrence after secondary prevention. After intervention ，plasma concentration of 4-HNE in drug intervention group and conventional treatment group was significantly lower than before intervention （P＜0.05）；there was no statistical significance between 2 groups（P＞0.05）. CONCLUSIONS ：Stroke family history ，artery atherosclerosis and the elevation plasma concentration of 4-HNE are independent risk factors associating with ischemic stroke recurrence after secondary prevention. Although drug intervention can reduce the elevated plasma concentration of 4-HNE，the effect of additional use of glutathione is not more significant than that of conventional treatment.
ABSTRACT
Traduzir, adaptar transculturalmente para o Brasil e analisar as propriedades psicométricas da versão brasileira do "Teste de rastreio do risco de queda no idoso" (Simple screening test for risk of falls in the elderly - "Q22").Métodos: Realizada a tradução e adaptação transcultural do "Q22". Selecionados idosos da comunidade, 60 anos ou mais, e apurados dados sociodemográficos, uso de medicações e queda no ultimo ano. Aplicada a versão brasileira do instrumento; Q22-p, visando a sua validação e análise de suas propriedades de medidas. Dois entrevistadores o aplicaram num mesmo dia e, após 15 dias, realizada nova aplicação por um dos entrevistadores. O TUGT e FRT também foram obtidos.Resultado: Amostra composta por 51 indivíduos, idade média 74,5 anos, principalmente mulheres, brancas, casadas e com baixa escolaridade. A frequência de queda no último ano foi 33%. Obteve-se uma ótima confiabilidade do Q22-p no Teste ANOVA de medidas repetidas (p=0,938) e no Índice de Correlação Intraclasses (96%; p<0.001). Na validação, apuradas correlações significativas do Q22-p com o TUGT e o FRT, segundo o Coeficiente de Correlação de Pearson, sendo regulares as correlações em ambos os testes, respectivamente, 38,2% (regular/baixa; p<0,001) e 55,1% (p=0,006). Obteve-se a curva ROC para o Q22-p e o escore 6,5 foi visto como o melhor ponto de corte no diagnóstico do risco de queda no idoso...