RESUMO
Objectives: Intravenous thrombolysis therapy (IVT) with recombinant tissue plasminogen activator has proven to be a beneficial treatment for acute ischemic stroke (AIS) patients when administered within 4.5 h after a stroke. This study aimed to investigate an available and inexpensive predictive tool for early neurological deterioration in AIS. Methods: Patients admitted to our department with acute stroke who were given IVT with recombinant tissue plasminogen activator within 4.5 h of stroke onset were included in the study. The NIH stroke scale (NIHSS) was used to assess patients' neurological state prior to IVT and for 24 h after. Early neurological deterioration was defined as occurring if the NIHSS total score increased by ≥ 4 or the NIHSS individual score increased by ≥ 2 compared to baseline. Patients were randomly assigned to training or validation cohorts. Results: Of the 266 AIS patients receiving IVT who were screened, 217 were deemed eligible for the study. Multivariate logistic regression analysis identified smoking history, NIHSS score, homocysteine level, and neutrophil to lymphocyte ratio as independent factors for predicting early neurological deterioration. ROC analysis was used to assess the quality of the resulting nomogram. The AUC for the training dataset was 0.826 (95 % CI, 0.719-0.932), and for the validation dataset was 0.887 (95 % CI, 0.763-1.000). Conclusion: The robustness of this nomogram suggests that it may be a reliable tool for evaluating the progression of AIS after IVT.
RESUMO
Objective: This study aims to study the correlation between serum ß2-glycoprotein I (ß2-GPI)/oxidized low-density lipoprotein (oxLDL) and the risk of cerebral infarction in patients with type 2 diabetes (T2DM). Methods: From January 2019 to March 2021, 56 patients with T2DM combined with cerebral infarction were chosen as a diabetic cerebral infarction (DCI) group, and 60 patients with simple T2DM were chosen as a T2DM group. In addition, 60 healthy volunteers were recruited as a control group. The essential information of each group was collected, and the serum ß2-GPI/oxLDL and inflammatory factor levels in each group were compared. The clinical factors that affect the risk of ischemic cerebral infarction in patients with T2DM were analyzed by a logistic model. Results: Compared with the control group, the level of serum ß2-GPI/oxLDL in the T2DM and DCI groups increased significantly, P < 0.001. Compared with the T2DM group, the serum ß2-GPI/oxLDL level in the DCI group increased significantly, P < 0.05. The result of Pearson's correlation analysis showed that serum ß2-GPI/oxLDL was positively correlated with total cholesterol, triglycerides, fasting blood glucose, 2-h postprandial blood glucose, glycosylated hemoglobin, interleukin-6, and tumor necrosis factor (TNF)-α (all P's < 0.05). Serum TNF-α and ß2-GPI/oxLDL were independent risk variates for DCI (P < 0.05). Based on the receiver operating characteristic curve analysis, the values of the area under the curve for TNF-α, serum ß2-GPI/oxLDL, and the combined diagnosis of DCI were 0.653 (0.552-0.753), 0.680 (0.583-0.777), 0.739 (0.647-0.831), respectively. Conclusion: In DCI patients, the levels of serum oxLDL/ß2-GPI are significantly increased. Serum oxLDL/ß2-GPI is an independent risk factor that affects the occurrence of DCI. In addition, the serum ß2-GPI/oxLDL level implicates the lipid metabolism and inflammatory status of the internal environment of DCI patients to a certain extent.
