Risk Factors Of Early Neurological Deterioration In Ischemic Stroke

Objective:Researching patients with acute ischemic stroke, progress to analyze risk factors of early neurological deterioration, so as to provide the basis for the prevention and treatment of progressing stroke.Methods:A total of286patients with stroke were enrolled from the neurology department of People Hospital of Heze,we’ll do a retrospective analysis.The selected stroke patients will be divided into early neurologic deterioration group and non-progressing stroke group based on if the neurological deficits symptoms were aggravated and the NIHSS score. The patients were compared in terms of their background characteristics, including age, sex, smoking and drinking history, body temperature, blood pressure,NIHSS score,history of hypertension and diabetes, medication history;blood test indicators:WBC、blood glucose、fibrinogen、blood lipids and sero-homocysteine, carotid artery ultrasound, Serum ferritin, urine specific gravity, high-sensitivity C-reactive protein CT/MRI,etc. Deal datas with statistical methods, Comparison of two groups of count data lines χ2test, measurement data t-test, p<0.05is considered statistically significant.Results:1. The overall incidence of END was30.42%. The most worsened during the first24hours after inclusion. With respect to the clinical characteristics,most appear arms or legs palsy progression.2.Hypertension differed significantly between END group and NEND group. Early blood pressure descend or up and pulse pressure decrease, hyperglycemia and Hyperthermia also had statistical significance (P≤0.005).3. The difference of leukocytosis、elevated C-reactive protein、Serum ferritin Baichao and sero-homocysteine between the two groups were significant. 4.The large area infarction、watershed infarction, stenosis in extracranial section of the internal carotid artery and middle cerebral artery were relevanted with END. The unstable plaque is relevanted with END too.5.The comparison of NIHSS score shows the admission score≥15were significantly different, indicating that the stroke severity of baseline is relevant with the occurrence of END. In addition, the return visit NIHSS score of END group≥15points is also statistically significant, indicating that END causes poor prognosis and high mortality.Conclusion:Neurological deterioration after acute ischemic stroke is a frequent phenomenon. A variety of factors combined with a variety of pathophysiological mechanisms effect progressing stroke.Hypertension and hyperglycemiaare are important factors of early neurologic deterioration,especially early drop in blood pressure, pulse pressure small, blood pressure variability. The fever after stroke onset was predictive factors of bad prognosis and deterioration. Leukocytosis、elevated C-reactive protein、Serum ferritin Baichao and sero-homocysteine are all the risk factors of early neurologic deterioration, the patients should be given the targeted therapy according to the cause. The large area infarction and watershed infarction are most prone to early neurological deterioration. Stenosis, especially the middle cerebral artery and extracranial internal carotid artery with severe stenosis or occlusion is an important factor of END.30-day prognosis of END group was significantly worse than NEND group, we should take some active preventive measures and symptomatic treatment.