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Objective:To investigate the relationship between cognitive function and brain event-related potential in patients with lacunar cerebral infarction.Methods:A total of 464 patients with lacunar cerebral infarction admitted to the Department of Neurology, Kailuan General Hospital from 2014 to 2019 were prospectively selected as observation subjects (case group). According to mini-mental state examination (MMSE) score, the patients in the case group were divided into 352 cases of lacunar cerebral infarction with normal cognition and 112 cases of mild cognitive impairment. At the same time, 100 healthy volunteers were selected as the control group. All subjects were assessed by simple intelligent mental state, Zung self-rating anxiety scale, Zung self-rating depression scale and brain event-related potential P3a and P3b. The measurement data of normal distribution adopts one-way ANOVA, the measurement data of non normal distribution adopts Kruskal Wallis H test, and the counting data adopts χ2. Multivariate statistical analysis was performed by unconditional Logistics (stepwise method). Results:The proportions of smokers in control group, lacunar cerebral infarction cognitive normal group and lacunar cerebral infarction mild cognitive impairment group were 20.00% (20/100), 38.07% (134/352) and 46.42% (52/112), respectively. The proportions of drinkers were 18.00% (18/100), 33.24% (117/352), 33.93% (38/112), respectively. The proportions of hypertension were 38.00% (38/100), 58.24% (205/352), 59.82% (67/112), respectively. The proportions of hyperhomocysteinemia were 19.00% (19/100), 34.00% (120/352) and 68.75% (77/112), respectively, and the differences among the three groups were statistically significant ( χ2 values were 15.66, 7.91, 11.86 and 54.57, respectively; P<0.001, 0.019, 0.003, <0.001). The peak latency CZ leads of visual P3b wave group N2 were (271.48±40.65), (285.67±44.08) and (290.57±68.41) ms, respectively. PZ leads were (276.70±50.92), (287.86±43.28) and (312.16±62.75) ms. P3b peak latency FZ leads were (392.67±42.50), (405.82±52.43) and (410.34±64.27) ms. CZ leads were (395.04±42.44), (412.51±55.86) and (433.28±66.32) ms. PZ leads were (398.24±40.93), (411.17±49.48) and (435.78±67.69) ms. N2 amplitude CZ leads were (-3.99±2.81), (-3.60±3.00) and (-2.70±2.37) μV, PZ leads were (-3.18±2.69), (-2.91±2.62) and (-1.87±2.89) μV, respectively. Leads P3b amplitude of FZ were 5.27 (3.27, 7.40), 4.21 (2.31, 6.49) and 3.12 (1.61, 5.08) μV. CZ leads were 4.81 (2.78, 6.71), 4.15 (2.76, 6.16) and 3.51 (1.75, 5.15) μV. PZ leads were 5.17 (3.03, 6.97), 4.40 (2.89, 6.12) and 3.43 (1.52, 5.34) μV. There were statistically significant differences among the 3 groups ( F=3.29, 14.49, 3.95, 11.73, 14.06, 5.66 and 3.57, H=18.23, 10.33,18.25; P=0.027, <0.001, 0.025, <0.001, <0.001, 0.004, 0.042, <0.001, 0.006, <0.001). The peak latency FZ leads of visual P3a wave group N2 were 265.00 (256.00, 286.00), 277.00(260.00,300.00), 282.00(270.00,304.00) ms, respectively. CZ leads weres 274.00(255.00,305.00), 285.00(262.00,329.00), 293.50(270.00,346.00) ms. P3a peak latency FZ leads were (413.83±49.58), (429.83±55.38) and (449.04±54.79) ms, CZ leads were (441.53±61.78), (457.12±69.29) and (460.23±72.24) ms. PZ leads were (430.14±54.53), (462.31±69.2) and (470.02±74.92) ms. N2 amplitude FZ leads were (-6.34±3.13), (-5.72±2.96) and (-4.92±2.05) μV, respectively. Leads P3a amplitude of FZ were 4.00 (2.28, 5.55), 3.15 (2.14, 4.91) and 2.80 (2.19, 4.19) μV. CZ lead were 3.37 (1.98, 4.66), 2.73 (1.70, 3.97) and 2.41 (1.64, 3.45) μV. There were statistically significant differences among the three groups ( H=13.92, 8.65, 9.17, 10.02, F=8.18, 6.33, 10.73, 4.62, P =0.001,0.013,0.010,0.007, <0.001,0.002, <0.001,0.010). Logistic regression analysis showed that alcohol consumption, P3b peak latency and wave amplitude PZ lead, N1 wave amplitude of visual P3a group FZ lead were the influencing factors of MMSE ( OR=0.04, 1.01, 0.76, 1.51, 95% Cl were 0.00-0.30, 1.00-1.03, 0.59-0.97, 1.08-2.10, P=0.002,0.007,0.029,0.016). Conclusion:The peak latency and amplitude of endogenous psychological cognitive potentials N2, P3b and P3a of event-related potentials P3b and P3a in patients with lacunar cerebral infarction were prolonged and decreased. At the same time, with the occurrence of clinical cognitive impairment, the peak latency and amplitude of these cognitive potentials were further prolonged and decreased more significantly. Alcohol consumption, P3b peak latency and PZ lead of visual P3b wave group, and FZ lead of N1 wave of visual P3a wave group were the influencing factors of simple intelligent mental state.
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OBJECTIVE:To study clinical effect of argatroban for progressive stroke patients of different cerebral ischemic ranges. METHODS:A total of 116 progressive stroke patients selected from neurology department of our hospital during Feb. 2015-May 2016 were divided into anterior circulation (ischemia) group (n=60),posterior circulation (ischemia) group (n=50) and lacunar(cerebral infarction)group(n=6)according to cerebral ischemic ranges. They all received routine treatment combined with argatroban,and given continuous intravenous infusion of argatroban 60 mg/d on the day and 2nd day of disease aggravation, and then continuous intravenous infusion of argatroban 5th day after relieving,3 h/time,bid,7 d as a treatment course. NIHSS scores,modified RANKIN (mRS) scores,APTT and ADR were compared among 3 groups. RESULTS:Forteen days after treat-ment,NIHSS scores and mRS scores of 3 groups were decreased significantly compared to before treatment,with statistical signifi-cance (P0.05). No obvious ADR was found in 3 groups. CONCLUSIONS:Argatroban shows significant therapeutic efficacy for progressive stroke of different ischemic ranges with good safety;especially for the patients with anterior circulation ischemics stroke,the effect is quick and anticoagulant effect is significant.
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Objective To observe the clinical curative effect of Danhong injection combined with atorvastatin calcium in the treatment of lacunar cerebral infarction of the elderly.. Methods 125 elderly patients with lacunar cerebral infarction were randomly recruited into two groups, a control group(n=60 cases) was treated with atorvastatin calcium on the basis of conventional symptomatic treatment, and an observation group (n=65 cases) was treated with Danhong injection combined with atorvastatin calcium on the basis of conventional symptomatic treatment, the courses of two groups were 14 d. The clinical curative effect, the degree of nerve function defect score, the changes of hemorheology of two groups before and after the treatment were compared. Results The total effective rate of the observation group(89.2%)was significantly higher than that of the control group(71.7%)(P<0.05). The degree of nerve function defect score(16.24±4.63)of observation group after treatment improved significantly better than that of control group(22.17±7.38), P<0.05, and the whole blood viscosity(high), whole blood viscosity(low), plasma viscosity and fibrinogen [(3.62±0.64)mPa?s,(8.07±2.45)mPa?s, (1.61±0.30)mPa?s, (2.76±0.28)g/L]decreased significantly than that of the control group[(4.73±0.85)mPa?s, (9.86±3.26)mPa?s, (2.05±0.33)mPa?s,(3.94±0.35)g/L], P<0.05. Conclusion The treatment of Danhong injection combined with atorvastatin calcium for elderly lacunar cerebral infarction had a good therapeutic effect. It could improve nerve function defect degree and blood rheology indexes.
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Objective To observe the effects of Danhong Injection in the treatment of lacunar cerebral infarction, Methods 82 patients with lacunar cerebral infarction were randomly recruited into a treatment group (n=42) and a control group (n=40). The treatment group was treated with Danhong Injection, 30ml/d for once, while the control group was treated with Danshen Injection, i.v. 20ml/day for once. Both groups were treated for 14 days. Results The total effective rate was 97.62% and 77.50% in the treatment group and the control group respectively, showing significant difference (χ~2=4.65, P< 0.05) . Conclusion Danhong Injection is better than Danshen Injection in treatment of lacunar cerebral infarction.
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Objective To explore the correlation between the recurrence rate of the elderly patients with lacunar infarction and the risk factors including blood pressure, blood glucose, total cholesterol, triglycerides,low density lipoprotein cholesterol values, high-density lipoprotein cholesterol and other. Methods 207 over 60 years old patients with lacunar infarction occurred the first time were included in the study. All patients were followed up two years to assess the relapse rate and the risk factors of the patients with lacunar infarction. Results 207 cases of elderly patients with lacunar infarction complicated with hypertension,type 2 diabetes and hyperlipidemia were 148 cases,22 cases,7 cases respectively, and the recurrence rates of three groups were 8.78%, 18.18%, 14.29% respectively;The patients complicated with hypertension and 2 type diabetes were 6 cases,and the recurrence rate was 34.62%;The patients without hypertension,type 2 diabetes and hyperlipidemia were 4 cases,and the recurrence rate was 0%. In two years,27 cases of lacunar infarction recurred,and the recurrence rate was 13.04%. Conclusion Hypertension,type 2 diabetes,hyperlipidemia could also be considered as the high-risk predictor factors for the recurrence rate of the elderly patients with lacunar infarction.
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Objective To investigate the change of serum C-reactive protein(CRP) levels in patients with acute cerebral infarction(ACI) and ACI with multiple organ dysfunction syndrome(MODS), and the relationship between serum CRP levels and incidence of MODS.Methods The serum CRP levels of 30 normal healthy people and 82 patients with ACI were detected by immune transmission turbidity method. The data from the patients with lacunar cerebral infarction(LCI), acute simple cerebral infarction(PACI) and ACI with MODS(ACI+MODS) were compared.Results The levels of serum CRP in patients with ACI significantly increased compared with the controls( P
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【Objective】To observe the hemorrheological changes in lacunar cerebral infarction(LCI) patients with arteriopathy of middle and small arteries.【Methods】The hemorrheological changes of cerebral arteries in 85 LCI patients without arteriopathy of large artery confirmed by cervical vessels color ultrasonography and magnetic resonance image(MRI)were observed by transcranial Doppler ultrasonography(TCD).The correlation of the hemorrheological changes with age and blood pressure(BP) of arteries was investigated.The above indexes were compared with those in 25 healthy volunteers confirmed by encephalography in the same age group.【Results】The mean blood flow rates of cerebral middle,anterior and posterior artery in LCI patients were(62.09?16.90)cm?s~(-1),(50.42?13.11)(cm?s~(-1),)and(32.33?7.55)cm?s~(-1) respectively,lower than(69.65?19.20)cm?s~(-1),(57.75?16.75)cm?s~(-1),and(38.75?8.81)cm?s~(1) respectively in the healthy volunteers(P0.05).【Conclusion】The arteriopathy of small artery in LCI patients can cause the mild decrease of blood flow rate and the increase of pulsating index.There exists a correlation of pulsating index with age and arterial blood pressure.