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Objective:To investigate the predictive value of serum C-type lectin-like receptor 2 (CLEC-2) combined with insulin resistance in the outcome of patients with acute ischemic stroke (AIS) after intravenous thrombolysis.Methods:Patients with AIS received alteplase intravenous thrombolytic therapy in the Department of Neurology, the Second Affiliated Hospital of Nantong University from October 2019 to March 2021 were enrolled retrospectively. According to the modified Rankin Scale score at 90 d after onset, they were divided into good outcome group (0-2) and poor outcome group (>2). Homeostasis model assessment of insulin resistance (HOMA-IR) was used to evaluate insulin resistance. Person correlation analysis was used to determine the correlation between CLEC-2 and HOMA-IR. Multivariate logistic regression analysis was used to determine the correlation between serum CELC-2, HOMA-IR and the outcome after intravenous thrombolysis. Receiver operating characteristic (ROC) curve was used to determine the predictive value of serum CLEC-2 combined with HOMA-IR for poor outcome after intravenous thrombolysis. Results:A total of 100 patients were enrolled (56 males, 56.0%; aged 70.6±10.86 years, range 49-83 years). The baseline National Institutes of Health Stroke Scale (NIHSS) score was 10.00±6.36. Senenty-four patients (74.0%) had a good outcome and 26 (26.0%) had a poor outcome. Person correlation analysis showed that there was a significant positive correlation between serum CLEC-2 and HOMA-IR ( r=0.523; P<0.001). Multivariate logistic regression analysis showed that after adjusting for confounding factors (C-reactive protein, baseline NIHSS score, onset-to-needle time), the highest quartile of serum CLEC-2 (compared with the lowest quartile: odds ratio [ OR] 4.836, 95% confidence interval [ CI] 1.105-21.169; P=0.036) and the highest quartile of HOMA-IR (compared with the quartile 1-3: OR 15, 95% CI 2.647-30.722; P=0.002) were the independent risk factors for the poor outcome in patients with AIS after intravenous thrombolysis. ROC curve analysis showed that the area under the curve for serum CLEC-2 combined with HOMA-IR to predict poor outcome was 0.785 (95% CI 0.688-0.883; P<0.001), the optimal cut-off value was 0.72, and the sensitivity and specificity were 76.0% and 95.0%, respectively. Conclusion:CLEC-2 combined with insulin resistance has a certain predictive value for the poor outcome of patients with AIS after intravenous thrombolysis.
RESUMEN
Objective:To explore the characteristics of illness perceptions and its effect on quality of life in adult epileptics.Methods:A cross-sectional study was conducted to evaluate 98 adult patients with epilepsy and 75 diabetic patients hospitalized at the same period.The Chinese illness perception questionnaire revised edition(CIPQ-R) was used to evaluate the differences in illness perception factors between the two groups.The quality of life in epilepsy-31(QOLIE-31) was used to assess the quality of life of 98 adult epilepsy patients and 55 healthy people, and the correlation analysis and multivariate regression analysis were used to investigate the effect of illness perceptions on the quality of life of epileptic patients.Results:The emotional representations factor score of CIPQ-R in the epilepsy group(21.73±5.79) was higher than that in the diabetes group (18.76±5.42) ( P<0.01). The scores of timeline acute/chronic, personal control and illness coherence factors of CIPQ-R in the epilepsy group((16.47±4.68), (20.91±4.03), (15.21±4.44)) were lower than those in the diabetes group ((19.16±4.75), (22.68±3.90), (16.56±3.73)) ( P<0.05). The scores of multiple factors in the quality of life scale of patients with epilepsy were lower than those in healthy controls( t=-2.264--8.203, P<0.01). Correlation analysis showed that the emotional statement dimension and consequences factors in CIPQ-R were significantly negatively correlated with the total scores of QOLIE-31 and all the other factors it belongs to ( r=-0.202--0.527, P<0.05); the identity, timeline acute/chronic, and timeline cyclical factors in CIPQ-R were negatively correlated with the total score of QOLIE-31 ( r=-0.272--0.342, P<0.01); the treatment control and illness coherence factors in CIPQ-R were positively correlated with the total score of QOLIE-31 ( r=0.259, r=0.307, P<0.01). Multiple stepwise linear regression showed that the identity, timeline acute/chronic, consequences, timeline cyclical, and emotional representations factors were important factors influencing the quality of life of adults with epilepsy. Conclusion:Adult epileptics have certain negative illness perceptions.Among them, identity, timeline acute/chronic, consequences, timeline cyclical and emotional representations factors have significant effects on the quality of life of adult epileptics.