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Objective To investigate the diagnostic value of multi‐slice spiral CTA on the SAH patients ,and serum S‐100B pro‐tein in the evaluation of brain damage and cerebral vasospasm in SAH patients .Methods One hundred and sixty six patients with SAH were selected ,and all underwent CTA examination ,the serum S‐100B protein level were detected 1 d ,2 d ,3 d and 7 d after ad‐mission .Results In the 166 patients ,CTA showed 119 aneurysms .With the treatment ,on day 1 S‐100B protein level of Ⅰ - ⅡHunt‐Hess grade patients was (0 .71 ± 0 .11)μg/L ,on day 7 the level was (0 .62 ± 0 .09)μg/L ;S‐100B level of Hunt‐Hess Ⅳ stage patients on day 1 and 7 were (2 .12 ± 0 .23)μg/L and (1 .97 ± 0 .06)μg/L .After treatment ,S‐100B level was proportional to Hunt‐Hess grade .S‐100B protein level of GCS(3-8) score patients were (1 .87 ± 0 .23)μg/L on day 1 and (1 .87 ± 0 .23)μg/L on day 7 .S‐100B protein level of GCS(13-15) score patients were(0 .63 ± 0 .17)μg/L on day 1 ,(0 .44 ± 0 .15)μg/L on day 7 .After treat‐ment ,the S‐100B level was inversely proportional to GCS score .Conclusion CTA could display three‐dimensional structure and the surrounding relations ,and could contribute to the choice of treatment and assessment of the degree of difficulty .Serum and cerebro‐spinal fluid concentration of S‐100B protein level could be used to assess the gravity of the secondary brain damage and the possibili‐ty of cerebral vasospasm .
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Objective To explore the relevant factors influencing the prognosis of progressive cerebral infarction,in order to provide basis for clinical trentment and improve the prognosis of patients.Methods Clinical data of 163 patients admitted as progressive cerebral infarction and 355 patients admitted as non-progressive cerebral infarction were retrospectively analyzed.All patients were followed up by interview or telephone at the time of 30 and 90days,the clinical data were recorded.The relevant factors influencing the prognosis of progressive cerebral infarction were analyzed.Results Multiple linear regression analysis of patients with progressive cerebral infarction showed that total anterior circulation infarcts,respiratory infection,coronary heart disease history,imbalance of water and electrolyte,white blood cell increasing were leading influence risk factors for the higher National Institutes of Health Stroke Scale(NIHSS) in hospitalized patients.Analysis of patients with progressive cerebral infarction showed that total anterior circulation infarcts,lack of physical activity,NIHSS at admitting,the elderly and respiratory infection were leading influence risk factors of the higher Activities of Daily Living(ADL) and modify Rankin Scale(mRS) scores at 30d and 90d of following up.The scores of ADL and mRS at 30d and 90d were significantly higher in progressive cerebral infarction than those of non-progressive cerebral infarction patients (t =6.6179,P =0.000,t =5.2788,P =0.000,t =5.0608,P =0.000,t =4.0725,P =0.000,respectively).The recurrence of cerebral infarction in progressive cerebral infarction group and death events at 30d were also significantly higher than that of non-progressive cerebral infarction(x2 =8.423,P =0.004 and x2 =5.135,P =0.023,respectively).But the recurrence of progressive cerebral infarction and death events at 90d,there were no significant differences between progressive cerebral infarction and non-progressive cerebral infarction (x2 =1.938,P =0.159 and x2 =3.518,P =0.061,respectively).Conclusion The relevant factors influencing the prognosis of progressive cerebral infarction are common effect of various factors.In the treatment of progressive cerebral infarction should be actively considered as much as possible to improve the prognosis of patients.
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Objective To study the effects of butylphthalide on homocysteine (Hcy) and C-reactive protein (CRP) levels in patients with acute cerebral infarction.Methods One hundred and ten patients with acute cerebral infarction were divided into control group and treatment group by random digits table,with 55 patients in each group.Two groups were given conventional treatment for 3 weeks,and treatment group was added butylphthalide 200 mg oral application,thrice a day.Two groups were compared in the total effective rate,neurological deficit scores (NDS) and serum Hcy and CRP levels.Results The total effective rate in treatment group was significantly higher than that in control group [ 89.09％ (49/55) vs.61.82％ (34/55),x2 =11.044,P＜ 0.01 ].The NDS in two groups after treatment were significantly decreased than those before treatment [treatment group:( 11.24 ± 3.19) scores vs.(23.19 ± 4.06) scores,control group:( 18.56 ± 4.03 )scores vs. (22.31 ± 4.17) scores,P ＜ 0.01 ],and NDS in treatment group after treatment was significantly lower than that in control group (P＜ 0.01 ).The serum Hcy and CRP levels in two groups after treatment were significantly lower than those before treatment [ treatment group:( 13.12 ± 3.58 ) μ mol/L vs.(27.36 ± 6.84 )μ mol/L,( 10.33 ± 3.10) mg/L vs.( 18.96 ± 5.38) mg/L;control group:( 16.41 ± 4.76) μ mol/L vs.(28.73 ±6.32) μ mol/L,(13.16±4.02) mg/L vs. (19.17 ± 5.74) mg/L,P ＜ 0.01 ],serum Hcy and CRP levels in treatment group after treatment were significantly lower than those in control group (P ＜ 0.01 ).Conclusion Butylphthalide can reduce serum Hcy and CRP levels,reduce inflammation and improve the condition of patients with acute cerebral infarction.
