ObjectiveTo observe the relationship between the serum level changes of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-18, intercellular adhesion molecule-1(ICAM1), matrix metalloproteinase (MMP)-9 and lipoprotein-associated phospholipase A2(Lp-PLA2), and the multiple factors of acute cerebral infarction (ACI). MethodsWe chose 76 patients with ACI treated between July 2012 and June 2014 as our study subjects.On the second day (acute phase) and the 15th day (recovery phase) after onset, we checked the patients for their serum levels of hsCRP, IL-18, ICAM1, MMP-9 and Lp-PLA2.Then, multiple linear regression analysis was performed to observe the correlation of the serum level change degree of inflammatory factors with hypertension, diabetes, coronary heart disease, smoking history, carotid atherosclerotic plaque, lipid levels, infarct size and National Institute of Health Stroke Scale (NIHSS) score. ResultsThe changes of all the inflammatory factors in the acute phase and the recovery phase of cerebral infarction were not significantly related to smoking history, hypertension, coronary heart disease, low-density lipoprotein and NIHSS scores (P > 0.05).The changes of hsCRP and ICAM1 had significant correlation with cerebral infarct size, diabetes mellitus and carotid atherosclerotic plaque (P < 0.05), and the change level of Lp-PLA2 was related to diabetes mellitus, and carotid atherosclerotic plaque (P < 0.05).MMP-9 serum level change had correlation with only cerebral infarct size (P < 0.05). ConclusionsSerum level changes of inflammatory factors are related to various factors of cerebral infarction.The main factors that affecting the serum level changes are cerebral infarction area, diabetes mellitus and carotid atherosclerosis.
Objective To assess the efficacy and safety of fructose-1,6 diphosphate (FDP) in the treatment of cerebral infarction. Methods We searched MEDLINE, EMbase, Cochrane CENTRAL Register of Controlled Trials, CBM and CNKI in 2006. Randomized controlled trials(RCTs) or quasi-randomized controlled trials involving FDP for cerebral infarction were collected. We assessed the quality of the studies and conducted meta-analyse with The Cochrane Collaboration’s RevMan 4.2. Results Ten RCTs were included, 9 of which were of low quality and only one was graded as high quality. None of the trials reported the number of patients who had died or were dependent at the end of long term follow-up. After 7 to 30 days of treatment, improvement of neurological deficiency was associated with FDP compared with placebo or control [OR 2.45, 95%CI (1.91,3.15)]. There was no statistical difference in the death rate between the FDP and control groups at the end of the treatment [RD –0.01, 95%CI (–0.03,0.01)]. One study found that FDP had a similar safety profile [OR 1.24, 95%CI (0.32,4.75)] to the control group. None of the trials compared the costs in the treatment groups. Conclusions The quality of the published clinical trials on FDP in the treatment of cerebral infarction is poor. FDP may improve short-term neurological deficits, but seems unlikely to decrease mortality. Moreover, we found no evidence to support the long-term efficacy of FDP on mortality, dependency and neurological deficit. Large-scale and high quality clinical trials with sufficient follow-ups are needed to evaluate the role of FDP in the treatment of cerebral infarction.
目的:初步探讨体外血浆脂蛋白过滤器（DELP）对急性脑梗死患者的临床疗效及安全性。方法:采用随机、基础治疗平行对照试验设计，将符合入选标准的患者随机分为两组:试验组3例，发病48 h内和间隔一天上午接受DELP治疗，对照组2例，仅给予基础治疗。用NIHSS量表，Barthel指数和改良Rankin评分评价神经功能恢复状况。结果:治疗后14 d治疗组NIHSS降低趋势明显优于对照组，治疗后90 d治疗组mRS良好预后的患者比例显著高于对照组。两组均未发现明显不良反应，治疗前后两组的实验室指标无显著变化。结论:DELP治疗急性脑梗死所致的神经功能缺损效果及安全性良好，为临床急性脑梗死的治疗提供了一条新的途径。
目的:探讨急性脑梗死的常规治疗和加用依达拉奉治疗的疗效变化。方法: 100例急性脑梗死患者随机分为治疗组和对照组,每组各50例,对照组用常规治疗方法(灯盏花和胞二磷胆碱静滴,口服阿司匹林等治疗),治疗组在常规治疗基础上加用生理盐水250mL+依达拉奉注射液30mg静脉滴注,每日2次,7～14天为1个疗程,进行疗效评定。治疗前、治疗后１４天和２１天对患者进行欧洲卒中评分(ESS)、日常生活活动能力(ＡＤＬ)评定。通过增分率判断疗效,同时记录不良反应。结果:治疗组１４天和21天评定ESS的有效率分别为78．0％和84．0％,对照组为52．0％和58．0％;１４天和２１天评定ＡＤＬ的有效率治疗组为８０.0％和８８．0％,对照组为56．0％和66．0％;治疗组无明显不良反应．结论:依达拉奉治疗急性脑梗死安全有效。
ObjectiveTo explore the association between prediabetes and poor outcome in patients with acute ischemic stroke (AIS).MethodsThe patients with first-ever AIS who were hospitalized in the Department of Neurology, the First Affiliated Hospital of Henan University of Science and Technology from September to December 2018 were retrospectively enrolled. According to the different levels of hemoglobin A1c, the patients were divided into prediabetes group, diabetes mellitus (DM) group and non-DM group. The outcome of the patients 3 months after the discharge was assessed by the modified Rankin Scale and dichotomized as good and poor outcomes. ResultsA total of 188 patients were included, and 160 were eventually included. Among them, 66 cases were in the non-DM group, 39 were in the prediabetes group, and 55 were in the DM group; 68 patients were in the poor prognosis group and 92 were in the good prognosis group. There was no statistically significant difference among the non-DM group, prediabetes group, and DM group (P>0.05) except for hyperlipidemia (χ2=7.781, P=0.020), triglyceride (TG) (F=8.220, P<0.001) and admission blood glucose (F=44.356, P<0.001). There was no statistically significant difference between the good prognosis group and the poor prognosis group (P>0.05) except for hyperlipidemia (χ2=4.847, P=0.028), admission blood glucose (t=−2.940, P=0.004), TG (t=−2.766, P=0.006), and NIHSS (Z=−6.038, P<0.001). Prediabetic [odds ratio (OR)=4.053, 95% confidence interval (CI) (1.491, 11.019)] and diabetic [OR=5.986, 95%CI (2.330, 15.379)] patients had a worse prognosis 3 months after the discharge.ConclusionIn adults with first-ever AIS, prediabetes and diabetes were associated with poor prognosis in patients with AIS after 3 months.
ObjectiveTo explore the association between prediabetes and early vascular cognitive impairment (VCI) in patients with acute cerebral infarction. MethodsNon-diabetes mellitus patients with first-ever acute cerebral infarction hospitalized in the Department of Neurology, the First Affiliated Hospital of Henan University of Science and Technology between January and April 2019 were retrospectively enrolled. The enrolled patients were divided into prediabetes group and normal blood glucose group according to the level of glycosylated hemoglobin, and the patients were divided into normal cognitive function group and cognitive impairment group according to the Montreal Cognitive Assessment score. The general information and clinical related data of the included patients were compared. Results A total of 129 patients were enrolled. Among them, 46 cases were in the prediabetes group and 83 cases were in the normal blood glucose group. There were 82 cases in the normal cognitive function group and 47 cases in the cognitive impairment group. Multivariate logistic regression analysis showed that compared with the normal blood glucose group, the prediabetes group was associated with early VCI in patients with acute cerebral infarction [odds ratio (OR)=4.172, 95% confidence interval (CI) (1.786, 9.754), P=0.001]; the higher the NationalInstitutes of Health Stroke Scale score at the first admission was, the higher the risk of early VCI was [OR=1.379, 95%CI (1.183, 1.650), P<0.001]. Conclusion In patients with first-ever acute cerebral infarction, prediabetes is associated with early VCI.
【摘要】 目的 探讨低场磁共振弥散加权成像（DWI）诊断急性脑梗死的价值。 方法 2007年7月-2009年9月对48例脑梗死患者行常规MRI扫描和DWI，分析不同时期脑梗死的DWI表现。 结果 在发病的超急性期及急性期，DWI病灶显示率均为100.0%，T2WI病灶显示率分别为37.5%、73.7%、100.0%。 结论 低场DWI对急性脑梗死的诊断准确率高，明显优于常规MRI。【Abstract】 Objective To investigate the diagnostic value of diffusion weighted imaging (DWI) in acute cerebral infarction. Methods From July 2007 to September 2009, 48 patients with ischemic stroke underwent conventional MRI and DWI, and the characteristics of DWI were analyzed. Results Abnormal DWI signals were displayed in all patients at hyperacute stage or acute stage, abnormal T2WI signals existed in 37.5%, 73.7%, and 100.0%, respectively. Conclusion DWI in low field MR is highly accurate in diagnosing acute cerebral infarction, which is superior to conventional MRI.
Objective To evaluate the effectiveness and safety of edaravone combined with Xingnaojing injection in the treatment of adult acute cerebral infarction. Methods Databases including PubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data were searched from inception to March 2012 to identify the randomized controlled trials (RCTs) on edaravone combined with Xingnaojing injection for adult acute cerebral infarction. Two reviewers independently selected the literature, extracted the data and assessed the methodological quality of the included RCTs, and then meta-analysis was performed using RevMan 5.0 software. Results A total of 9 RCTs involving 1 098 patients were included. The results of meta-analyses showed: a) The edaravone combined with Xingnaojing injection group was superior to the Xingnaojing injection group with significant differences in the effective rate (OR=3.43, 95%CI 2.44 to 4.82, Plt;0.000 01), significantly-effective rate (OR=2.33, 95%CI 1.78 to 3.05, Plt;0.000 01), mortality (OR=0.38, 95%CI 0.15 to 0.95, P=0.04), ESS score after treatment (7 days after treatment: SMD=–0.48, 95%CI –0.80 to –0.17, P=0.003; 14 days after treatment: SMD=–0.89, 95%CI –1.17 to –0.62, Plt;0.000 01; 1 month after treatment: SMD=–0.89, 95%CI –1.20 to –0.59, Plt;0.000 01) and NDS score after treatment (7 days after treatment: MD=10.42, 95%CI 4.78 to 16.05, P=0.000 3; 14 days after treatment: MD=13.82, 95%CI 12.86 to 14.79, Plt;0.000 01; 21 days after treatment: MD=10.33, 95%CI 4.43 to 16.23, P=0.000 6); and b) The edaravone + Xingnaojing injection + conventional therapy group was superior to the conventional therapy group with significant differences in the effective rate (OR=3.03, 95%CI 1.36 to 6.73, P=0.006), significantly-effective rate (OR=2.86, 95%CI 1.50 to 5.44, P=0.001) and ESS score after treatment (7 days after treatment: MD=–6.26, 95%CI –8.49 to –4.03, Plt;0.000 01; 14 days after treatment: MD=–6.43, 95%CI –8.73 to –4.13, Plt;0.000 01). Conclusion Current evidence shows edaravone combined with Xingnaojing injection is obviously superior to either Xingnaojing injection or conventional therapy for adult acute cerebral infarction. But this conclusion still needs to be further proved by more high-quality and large-scale RCTs because of the low quality of the included studies.