ABSTRACT
Objective To evaluate the correlation between serum uric acid with cognitive disorder after acute cere?bral infarction by prospective study. Methods Four hundred consecutively enrolled patients of acute cerebral infarction were divided into no cognitive impairment group and cognitive impairment group according to the assess of Montreal Cog?nitive Assessment (MoCA). Univariate analysises were conducted in the potential risk factors of cognitive impairment in?cluding age, sex, smoking, alcohol, hypertension, diabetes, dyslipidemia, level of education, infarction in key parts, atrial fibrillation, serum uric acid, blood homocysteine between two groups. The statistically significant indicators in univariate analysises were used as independent variables and the scores of MoCA were used as the dependent variable to conduct multiple linear regression analysis. The assessment on the risk of cognitive impairment after cerebral infarction were con?ducted according to serum uric acid, sex, age and TOAST classification further. Results Serum uric acid was indepen?dent risk factors of cognitive disorder after acute cerebral infarction. The risk of cognitive disorder after acute cerebral in?farction was significantly increased in patients with high level of serum uric acid than with normal level and the relative risk was 1.35,95%CI(1.098,1.660). Especially for the young, male or patients with cerebral infarction in classification of small artery occlusion, the risk increased further, and the relative risk was 1.513, 95%CI(1.092, 2.096)1.412, 95%CI (1.125, 1.771)and 1.464, 95%CI(1.128, 1.900)respectively. Conclusion Exaltation of Serum uric acid was indepen?dent risk factor of cognitive disorder after acute cerebral infarction. The risk of cognitive disorder after acute cerebral in?farction was significantly increased in patients with high level of serum uric acid than with normal level, and especially for the young, male and patients with cerebral infarction in classification of small artery occlusion, the risk increased fur?ther.
ABSTRACT
Our objective was to determine whether continuous transcranial Doppler (TCD) monitoring could safely enhance the efficacy of batroxobin, a thrombin-like enzyme extracted from Bothrops atrox moojeni venom, in the treatment for acute cerebral stroke beyond the thrombolytic time window. Ninety patients suffering an acute cerebral stroke were recruited into the study within 12 hours after the onset of symptoms. Patients were randomized to receive batroxobin with (target group) or without 1 hour of continuous TCD monitoring (control group). Clinical evaluation of stroke was based on the National Institutes of Health Stroke Scale (NIHSS) score, Barthel index (BI), Thrombolysis in Brain Ischemia score (TIBI), the incidence of advancing stroke, and the recurrence of cerebral infarction. The patients receiving continuous TCD monitoring showed significant improvement in NIHSS score at 57 days post treatment compared with the control. Similarly, patients receiving continuous TCD monitoring also showed significant improvement in BI at 3 months compared with the controls. Consistently, both the incidence of advancing stroke after 1 week and the incidence of stroke recurrence after 3 months were significantly lower in TCD monitored group than control group. Moreover, the safety of the employment of TCD monitoring in the treatment of these patients was confirmed as there was no significant difference of the incidence of intracranial hemorrhage at 1 week after the treatment between the target and control groups. Taken together, our study showed that batroxobin, in combination with continuous TCD monitoring at the middle cerebral artery, reduced the incidence of advancing stroke and stroke recurrence after treatment without adverse effects in terms of poststroke intracranial hemorrhage.
Subject(s)
Batroxobin/administration & dosage , Fibrinolytic Agents/administration & dosage , Stroke/diagnostic imaging , Stroke/drug therapy , Ultrasonography, Doppler, Transcranial/methods , Adult , Aged , Female , Humans , Infusions, Intravenous , Male , Middle Aged , Monitoring, Physiologic/methods , Prognosis , Reference Values , Risk Assessment , Severity of Illness Index , Statistics, Nonparametric , Stroke/mortality , Survival Rate , Treatment OutcomeABSTRACT
Objective To observe the influence of Gastrodia data capsule on cerebral blood flow in the treatment of patients with hypertension.Methods A total of 69 patients with hypertension were divided into the treatment group(36 cases) and the control group(33 cases).The treatment group received treatment of Gastrodia clara capsule combined with antihypertensive drug,the control group received treatment of antihypertensive drug only.Two groups received TCD test before and 20 days after treatment,and the changes of blood flow of intracranial vessels before and after treatment were assessed.Results The total effective rate in treatment group was 97.2％,12 cases cured,15 cases of tangible effectiveness,8 cases of effectiveness,1 case of invalidity.The total effective rate in control group was 75.8％,7 cases cured,12 cases of tangible effectiveness,6 cases of effectiveness,8 case of invalidity,The difference of clinical efficacy between the two groups was statistically significant ( Z =2.240,P ＜ 0.05 ).The mean velocity of MCA,ACA,PCA,BA,VA of control group 20 days after treatment was not statistically different compared to those before treatment.The mean velocity of MCA,ACA,PCA,BA,VA of treatment group 20 days after treatment was lower than those before treatment(t =-2.65,-2.44,-3.92,-3.31,-4.68,all P＜0.05).Conclusion The treatment of Gastrodia elata capsule conbined with antihypertensive drug can significantly improve curative effect of patients with hypertension and improve the condition of cerebral blood flow.
