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Objective To explore the application of ABCD3 score on stratifying the antithrombotic treatment strategy in patients with capsular warning syndrome (CWS).Methods The clinical features of 15 patients with CWS were analyzed retrospectively,and the risk of stroke were evaluated by ABCD3 score and to guide the treatment of Stratifying antithrombotic therapy.The status of patients hospitalized,discharged and discharged after 90 d were evaluated.Results The frequency of patients with CWS accounted for 2.51％ (15/ 597) of all patients with transient ischemic attack(TIA),and the mean age in patients with CWS was (70.27 ±8.29) years old.The duration of the first onset was (10-30) min,the mean time was (17.33±1.53) min,and ABCD2 score was 5.0-9.0 points,mean score was 7.00±0.26 points,and the total episodes of CWS were 51 times during 24 hours,the mean duration was (18.13 ± 15.36) minutes ((3.0-60.0) min).All 15 cases presented with limb hemiparesis.Of them,9 cases had dysarthria,5 case with ipsilateral facial palsy.All 15 cases CWS patients showed no signs of cortical deficit.The mean NIHSS score at onset was 1.0-6.0 points,mean scores was 3.20±0.31 points.Fourtheen patients were treated with clopidogrel plus aspirin,and 2 cases with administration of the loading dose 300 mg of clopidogrel,1 case was treated with clopidogrel plus aspirin orally followed by intravenous rt-PA thrombolysis.The average hospital periods of all 15 patients was (7.67±0.29) days.The NIHSS score were 0 point at discharge.There was no symptomatic intracranial hemorrhage or death within 90 days follow-up periods.Conclusion CWS is prone to develop a completed stroke.Stratified antithrombotic therapy guiding by ABCD3 score may decrease the risk of ischemic stroke.
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Objective To explore the relationship of a polymorphism c.757T ＞ C in C-reactive protein gene (CRP) and carotid artery atherosclerosis in patients with ischemic cerebrovascular disease (ICVD).Methods A case-control study investigated 276 ICVD patients and 125 controls matched for age and sex.Genotypes of-757T/C in CRP were analyzed in patients with ICVD using polymerase chain reaction-restriction fragment length polymorphism.The level of serum C-reactive protein was detected by using immune scatter turbidimetry and the intima-media thickness of common carotid artery and internal carotid artery were measured by color Doppler ultrasonography.The relationship between the polymorphism -757T/C in CRP and carotid atherosclerosis was assessed.Results The genotypes of the polymorphism -757T/Cin CRP in the ICVD group (207/276(75.0％),65/276(23.6％),4/276(1.4％)) was significantly different from the control group (75/125 (60.0％),46/125 (36.8％),4/125 (3.2％) ; x2 =9.531,P =0.008),the frequence of T allele in patients with ICVD (479/552(86.8％)) was increased significantly compared to the control group (196/250 (78.4％)),the frequence of C allele in the ICVD group (73/552(13.2％)) was decreased significantly in contrast to the control group (54/250 (21.6％) ;x2 =9.056,P =0.004).Among the patients with ICVD,the level of serum C-reactive protein in patients with-757TC/CC genotype was elevated significantly than that with-757TC/CC ((4.2± 1.6) mg/L vs (2.7 ± 1.9) mg/L; t =5.900,P ＜ 0.01).Logistic regression analysis demonstrated that the-757C allele in CRP was related to the carotid artery atherosclerosis (OR =1.379,95％ CI 0.852-0.864,P =0.023).Conclusions The polymorphism-757T/C in CRP maybe related to the risk of developing ICVD.The frequency of the-757C allele can increase the level of serum C-reactive protein.And this polymorphism may be associated with carotid artery atheroselerosis in patients with ICVD.