Résumé
Objective:To investigate the prognosis of pediatric arterial ischemic stroke(PAIS).Methods:We retrospectively analyzed the clinical data of patients aging from 1 month to 18 years old who were diagnosed with PAIS at the Emergency Department of Beijing Children′s Hospital from July 2015 to April 2020.We used the modified Rankin scale(MRS)to evaluate patients.We analyzed their recovery of neurological function, mortality rates, and the recurrence of PAIS, while statistically calculating the risk factors leading to disability and death caused by PAIS.Results:A total of 101 children with PAIS were involved.During the follow-up period, 32.7%(33/101)had no obvious neurological sequelae(MRS 0), and 24.8%(25/101)had mild symptoms that did not affect the patients′daily life(MRS 1). The proportion of mild disability(MRS 2)and moderate to severe disability(MRS 3-5)were 13.9%(14/101)and 9.9%(10/101), respectively.Notably, 18.8%(19/101)of the patients died during the follow-up period, and PAIS-related fatality rate was 7.9%.Of the 49 patients with MRS score of 1-5, 89.8%(44/49)had dyskinesia, 16.3%(8/49)had language disorder, 10.2%(5/49)had epilepsy, 10.2%(5/49)had intellectual impairment, and 4.1%(2/49)had memory impairment.Four children relapsed during the follow-up period.Infantile onset, cardiogenic stroke, consciousness disorder and multiple angiopathy may be the risk factors of severe disability and death of PAIS.Conclusion:PAIS has a certain probability of mortality and disability.Infantile onset, complicated with consciousness disorder, cardiogenic stroke and multiple angiopathy are risk factors for poor prognosis.
Résumé
Objective To investigate the effect of argatroban in repair of spinal cord injury in rats.Methods A total of 54 female Wistar rats were selected and divided into three groups according to the random number table:sham group,injury group and Argatroban group,with 18 rats in each group.The sham group only took the T101amina;the injury group used the spinal cord injury device to make the rat spinal cord injury model;the Argatroban group received Argatroban treatment after spinal cord injury.The recovery of hindlimb motor function was evaluated by BBB score and clined plate test before injury and 7,14,21,28,35 and 42 days after injury.The sensory evoked potentials (SEP) and motor evoked potentials (MEP) were detected 42 days after operation.HE staining was used to compare the size of the cavity in the local region 42 days after injury.Results At day 7 after injury,the BBB score was (3.7 ±0.5) points and the inclined plane test was (28.0 ± 2.6) ° in the Argatroban group,which were better than those in the injury group [(3.3 ± 0.5) points,(24.3 ± 1.9) °] (p ＜ 0.05).At day 42 after injury,the BBB score was (13.0 ± 0.8) points and inclined plane test was (50.7 ± 2.7) ° in the Argatroban group,which were significantly better than those in the injury group [(9.7 ± 1.3) points,(40.5 ± 2.7)°] (p ＜0.05).But all the above values in the Argatroban group were significantly lower than those in the sham group [(21.0 ± 0.0) points,(60.0 ± 0.0) °] (P ＜ 0.05).At day 42 after operation,the SEP latency [(25.0 ± 0.9)ms] in the Argatroban group was significantly shorter than that in the injury group [(31.5 ± 1.9) ms];the amplitude [(2.1 ± 0.1) μV] in the Argatroban group was lower than that in the injury group [(0.5 ± 0.1) μV] (P ＜ 0.05).The MEP latency [(11.5 ± 1.0) ms]in the Argatroban group was significantly shorter than that in the injury group [(17.5 ± 1.1) ms],and the amplitude [(4.8 ± 0.8) μV] in the Argatroban group was lower than that in the injury group [(2.8 ± 0.7) μV] (P ＜ 0.05).And the SEP or MEP latency and amplitude in the Argatroban group showed significant differences compared to the sham group [(7.5 ± 1.0) ms,(7.5 ± 1.0) μV] (P ＜0.05) . HE staining showed that the central area of the lesion in the Argatroban group [(0.35 ± 0.04) mm2]was significantly smaller than that in the injury group [(0.71 ± 0.05)mm2].Conclusion After spinal cord injury,argatroban can protect the spinal cord tissue effectively in the injured area and promote recovery of sensory and motor function in the hind limbs of rats.
Résumé
Objective@#To investigate the effect of argatroban in repair of spinal cord injury in rats.@*Methods@#A total of 54 female Wistar rats were selected and divided into three groups according to the random number table: sham group, injury group and Argatroban group, with 18 rats in each group. The sham group only took the T10lamina; the injury group used the spinal cord injury device to make the rat spinal cord injury model; the Argatroban group received Argatroban treatment after spinal cord injury. The recovery of hindlimb motor function was evaluated by BBB score and clined plate test before injury and 7, 14, 21, 28, 35 and 42 days after injury. The sensory evoked potentials (SEP) and motor evoked potentials (MEP) were detected 42 days after operation. HE staining was used to compare the size of the cavity in the local region 42 days after injury.@*Results@#At day 7 after injury, the BBB score was (3.7±0.5)points and the inclined plane test was (28.0±2.6)° in the Argatroban group, which were better than those in the injury group [(3.3±0.5)points, (24.3±1.9)°] (P<0.05). At day 42 after injury, the BBB score was (13.0±0.8)points and inclined plane test was (50.7±2.7)° in the Argatroban group, which were significantly better than those in the injury group [(9.7±1.3) points, (40.5±2.7)°] (P<0.05). But all the above values in the Argatroban group were significantly lower than those in the sham group [(21.0±0.0)points, (60.0±0.0)°](P<0.05). At day 42 after operation, the SEP latency [(25.0±0.9)ms] in the Argatroban group was significantly shorter than that in the injury group [(31.5±1.9) ms]; the amplitude [(2.1±0.1)μV] in the Argatroban group was lower than that in the injury group [(0.5±0.1)μV] (P<0.05). The MEP latency [(11.5±1.0)ms] in the Argatroban group was significantly shorter than that in the injury group [(17.5±1.1)ms], and the amplitude [(4.8±0.8)μV] in the Argatroban group was lower than that in the injury group [(2.8±0.7)μV] (P<0.05). And the SEP or MEP latency and amplitude in the Argatroban group showed significant differences compared to the sham group [(7.5±1.0)ms, (7.5±1.0)μV](P<0.05). HE staining showed that the central area of the lesion in the Argatroban group [(0.35±0.04)mm2] was significantly smaller than that in the injury group [(0.71±0.05)mm2].@*Conclusion@#After spinal cord injury, argatroban can protect the spinal cord tissue effectively in the injured area and promote recovery of sensory and motor function in the hind limbs of rats.