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Objective To investigate the value of serum uric acid and brain natriuretic peptide in the evaluation of progressive ischemic stroke.Methods Totally 63cases of progressive ischemic stroke patients in our hospital from October 2016to October 2017were selected as the observation group.According to the severity of the disease, the patients were divided into mild group[National Institute of Health Stroke Scale (NIHSS) score＜7], medium group (NIHSS score 7-15) and severe (NIHSS score＞15).Meanwhile, 60cases of nonprogressive ischemic stroke patients in the hospital from January 2014and December 2016were selected as the control group.After admission, 3 mL fasting peripheral venous blood was collected in each subject in both groups, and the serum was isolated.Enzyme-linked immunosorbent assay (ELISA) was used to determine the level of brain natriuretic peptide and uric acid/eroxidase coupling method was used to determine the level of serum uric acid.Results The levels of serum uric acid and brain natriuretic peptide were significantly higher than those of the control group (P＜0.05).The levels of natriuretic peptide and serum uric acid in severe group were significantly higher than those of mild group and medium group, and the levels of two indicators in medium group were significantly higher than those of mild group (P＜0.05).In addition, the sensitivity and specificity of combined detection were significantly higher than the single index detection of serum uric acid and brain natriuretic peptid (P＜0.05).Conclusion The combined detection of serum uric acid and brain natriuretic peptide have higher sensitivity and specificity.
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Objective To analyze the related influencing factors of progressive ischemic stroke, and to investigate the value of serum markers for prediction of progressive ischemic stroke. Methods Three hundred and six patients with acute cerebral infarction were divided into progressive ischemic stroke (PIS) group (n=91) and non-progressive ischemic stroke (NPIS) group (n=215). Data of gender, age, past medical history, personal history and serum markers were collected and compared in two groups. Binary Logistic regression was used to analyze the influencing factors of PIS. The receiver operating characteristic (ROC) curves of neutrophils to lymphocytes ratio (NLR), fibrinogen and fasting blood glucose were analyzed in two groups. Results Positive rates of hypertension history, diabetes history, hypercholesterolemia history, incidence of large artery atherosclerotic (LAA) stroke were significantly higher in PIS group than those in NPIS group ( P<0.05). The levels of neutrophils, NLR, fibrinogen and fasting blood glucose were significantly higher, but the level of lymphocytes was significantly lower in patients with PIS than those in patients with NPIS (P<0.05). Logistic regression analysis confirmed that diabetes, LAA stroke, NLR, fibrinogen and fasting blood glucose were independent risk factors for the PIS ( P<0.05). The areas under ROC curve by NLR, fibrinogen and fasting blood glucose were 0.777, 0.560 and 0.574, respectively. The sensitivities of NLR, fibrinogen and fasting blood glucose were 72.5%, 59.8%and 47.3%, respectively;and the specificities were 76.7%, 51.2% and 69.8%, respectively. Conclusion The occurrence of PIS is related with blood pressure, blood lipids, inflammatory cells in peripheral bolld, fibrinogen and fasting blood glucose. The level of NLR in peripheral blood can predict the occurrence of PIS, which can be used as an important reference index for early diagnosis of PIS.
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Objective To observe the changes of fasting plasma glucose (FPG) and glycated hemoglobin(HbAcl) in patients with progressive ischemic stroke(SIP),and to provide scientific basis for the prevention and treatment of SIP.Methods Two hundred and twenty-one cases of acute ischemic stroke in Aerospaceplane General Hospital of Beijing were enrolled in this study.They were divided into progressive ischemic stroke group(123 cases) and non-progressive ischemic stroke group(98 cases) according to the NIHSS score.The changes of FPG and FPG were observed and compared between the two groups after admission to the hospital.Results The incidence of diabetes in group SIP (51.22％,63/123) was significantly higher than that in non SIP group(15.31％,15/98),and the difference was statistically significant(P=0.000).The FPG and HbAlc of SIP group were (8.35± 3.76) mmol/L,(7.31 ± 2.07) ％,of non SIP group were (6.47± 2.86)mmol/L,(6.25± 1.31)％,the difference between the two groups was statistically significant (P =0.000).Distribution rate of FPG＜6.1 mmoL/L,6.1 mmol/L ≤FPG＜7.0 mmol / L,FPG≥7.0 mmol/L in SIP group patients were 38.21％,14.64％,47.15％ respectively,in non SIP group were 64.39％ and 16.33％,19.39％ respectively,the differences between the two groups were statistical significance(P=0.000).Distribution rate of HbA1c≤7.0％,7.0％＜HbA1c ≤.0％,HbA1c＞9.0％ of patients in the SIP group were 53.66％ (66/123),25.20％(31/123),21.14％(26/123) respectively,and in non SIP group were 79.59％(78/98),16.33％(16/98),4.08％ (4/98) respectively,the differences between the two groups were statistical significance (P =0.000).Conclusion The occurrence and development of SIP is not only related to diabetes,but also closely related to blood glucose and HbA1c levels.High blood glucose and high levels of HbA1c have important significance for early identification and prediction of SIP.
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Objective To explore the role of plasma level of homocysteine ( Hey ) in progressive ischemic stroke (PIS)of carotid artery system and to investigate the relationship between Hcy and carotid artery atherosclerosis(AS).Methods Plasma Hcy concentrations were measured in 68 patients with progressive ischemic stroke of carotid artery system (PIS group)and 72 patients with non-progressive ischemic stroke of carotid artery system ( non-PIS group ).Plasma Hcy level and carotid artery intima-media thickness ( IMT ) were compared among PIS group and non-PIS group as well as normal control group.The linear correlation between plasma Hcy level and IMT in PIS group was analyzed.Results Plasma Hcy concentrations was respectively (22.52 ± 5.26) μmol/L,( 16.38 ± 4.23) μmol/L and( 10.13 ± 2.16) μmol/L in PIS group,non-PIS group and normal control group( F =56.87,P ＜ 0.01 ).Compared PIS group and non-PIS group with normal control group,the differences were statistically significant ( P ＜ 0.01 ).And there was also significant difference on plasma Hcy levels between PIS group and non-PIS group( P ＜ 0.01 ).The thickness of carotid artery IMT was respectively(1.12 ± 0.34)mm,(0.96 ± 0.27)mm and(0.43 ± 0.21 )mm in PIS group,non-PIS group and normal control group( F =28.47,P ＜ 0.01 ).Compared PIS group and non-PIS group with normal control group,the differences were statistically significant( P ＜ 0.01 ).And there was also significant difference on IMT between PIS group and non-PIS group ( P ＜ 0.01 ).In PIS group plasma Hcy level was positively correlated with the carotid artery IMT ( r =0.687,P ＜ 0.01 ).Conclusion The plasma Hcy level is closely related to the occurrence and development of carotid artery atherosclerosis and PIS of carotid artery system,detection of plasma Hcy level helps to predict the occurrence of PIS of carotid artery system and provide an evidence for the therapy decision.
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Objective To investigate the clinical efficacy and safety evaluation of fibrinolytic,anticoagulant and antiplatelet drug combination treatment in patients with progressive ischemic stroke (PIS). Methods Ninety cases with PIS were randomly divided into the treatment group (47 cases) and the control group (43 cases). The patients in the control group were given combination therapy of Diemailing, Nadroparin calcium and Ozagrel,while the combination therapy of Defibrase, Diemailing, Nadroparin Calcium and Ozagrel were given in the treatment group. The plasma fibrinogen (Fib), prothrombin time (PT), part enabled prothrombin time (APTT), liver and kidney function were observed. The clinical efficacy was evaluated after 14 days treatment. Results After treatment,the total effective rate of the treatment group was 89.4% ,which was significantly higher than that of the control group (67.4%) (P ＜ 0.05). After treatment, the PT and APTT levels of the treatment group were respectively (19.76± 5.53)s and (35.43 ± 6.03)s,the control group were respectively(17.26 ± 1.49)s and (35.71±5.64) s, the PT and APTT increased significantly compared with the pre-treatment condition in both groups (P ＜ 0.05), while the difference between the two groups was not statistically significant (P ＞ 0.05). The Fib level was (1.51 ±0.42)g/L in the treatment group,and (3.10 ±0.69)g/L in the control group. In the treatment group the Fib level was significantly lower than the control group and the condition before treatment(P ＜0.05). We found no significant difference between conditions before or after the treatment in the control group (P ＞ 0.05). The incidence of adverse clinical events showed no significantly difference between the treatment group and control (P ＞0.05). Conclusions Applying of fibrinolytic, anticoagulant and antiplatelet drug combination treatment in patients with PIS has a good efficacy and safety,which is good for clinical application.
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Objective To study the level changes of matrix metalloproteinase-9 (MMP-9)and its clinical significance in patients with progressive ischemic stroke(PIS).Methods 136 cases of acute ischemic stroke including 46 cases of PIS and 90 cases of non-PIS,were studied.56 healthy subjects were selected into control group.MMP-9 level was measured by ELISA at 2,7 and 14 day after admission.The neurologic dysfunction score was observed.Results The MMP-9 level was ( 249.43 ± 63.76)μg/L,( 271.50±72.08 )μg/L,and (183.20 ±66.69)μg/L in PIS group,while it was (158.81±49.18 )μg/L,( 188.67±57.96 )μg/L,and ( 93.86 ±22.16)μg/L in non PIS group and was (88.60±15.93 )μg/L in control group at 2,7 and 14 days of admission.The MMP-9 level of PIS group at 2,7 and 14 day and the level in non PIS group at 2 and 7 day were higher than that of control group(P＜0.01 ).The MMP-9 level of PIS group was higher than that of different phrase of PIS group (P＜0.01 ).Linear X2 showed that the increase of MMP-9 level would increase the risk of ischemic stroke progression( X2=38.96,P＜0.01 ).Conclusion The remarkable increase of MMP-9 in patients with progressive ischemic stroke may be the indepent risk factor of the progression of ischemic stroke.
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Objective To observe the clinical effects and safety of preventing progressive cerebral infafction failure to be controlled by Aspirin with the low-molecular-weight heparin combined with traditional Chinese medicine.Methods All cases diagnosed by CT SCan to be progressive cerebral infarction were randomly recruited into a control group and a treatment group,with 48 cases in each group.The treatment group was treated with low molecular heparin of 4000u/times,twice/day for 7 days MS and then was administrated with warfarin and Daqinjiao decoction.The control group was treated with aspmn of 200mg/day for 7 days and 150mg/day for the rest.Neurological deficit SCOre and efficacy evaluation was assayed 30 days before and after the treatment.Results Clinical results showed that the therapeutic effects oftlle treatment group Was much better than the control group(P＜0.05).Besides the incidence of serious bleeding complications were mcreasmg.Conclusion Low molecular heparin combined with traditional Chinese medicine is effective and safe to treat the patients of progresmve cerebral infaretion whose disease failed to be controlled bv Aspirin.
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Objective To explore the preventive role of low molecular weight heparin in progressive ischemic stroke.Methods 203 patients with cerebral infarction within 72 hours of the onset were randomly divided into low molecular weight heparin(LMWH) group and routine treatment group.LMWH group was administered subcutaneously twice daily for 5~10 days with 0.4 mL LMWH on the basis of routine treatment. The activities of plasminogen and coagulation factor Ⅹ and the indexes of hemorrheology were measured before and after the treatment, the neurologic function deficits of patients with progressive ischemic stroke were evaluated.Results 11 cases for progressive ischemic stroke were occurred in LMWH group, 23 cases in routine treatment group for progressive ischemic stroke, there was remarkable difference between the two groups( P