The Study Of Risk Factors Of Wake Up Stroke

Objective: Ischemic stroke can be divided into wake-up stroke(WUS)and non-wake-up stroke(NWUS)according to the onset time.WUS refers to the stroke that occurs in sleep,which accounts for around 25% of all ischemic strokes.Age,hypertension,atrial fibrillation and hyperlipidemia have been identified as risk factors for ischemic stroke.The purpose of this study is to explore the particularity of risk factors for wake-up stroke,and to provide reference and guidance for the prevention and treatment of wake-up stroke.Methods: Patients with acute ischemic stroke were hospitalized in neurology department of our hospital from January 2018 to October 2018.According to the onset time of all enrolled patients,they were divided into WUS group and NWUS group.We collected the general clinical indicators and biochemical indicators of the patients.All patients were under the24-hour ambulatory blood pressure monitoring.The 24-hour,diurnal and nocturnal blood pressure variability were calculated respectively,and the standard deviation and coefficient of variation were used to characterize the blood pressure variability.All indicators were analyzed by single factor analysis.The factors with statistical differences(P < 0.05)were included in multivariate Binary Logistic Regression Analysis to analyze the risk factors of stroke after awakening.Results: A total of 219 patients were enrolled in the study,with 48 wake-up strokes and 171non-wake-up strokes included.Univariate analysis showed that there was no significant difference between WUS and NWUS patients,in terms of age,sex,BMI,smoking,drinking,hypertension,diabetes,coronary atherosclerotic heart disease,stroke,homocysteine,fasting blood glucose,glycosylated hemoglobin,uric acid,fibrinogen,cholesterol,triglyceride and high density lipoprotein.There was no significant difference in 24 hours,diurnal and nocturnal blood pressure variability between the two groups(P> 0.05).There were statistical differences in the history of atrial fibrillation and low density lipoprotein.Atrial fibrillation(22.917% VS 10.526%,P= 0.032),low density lipoprotein(2.944±1.183 VS 2.554±0.961,P= 0.019)in the WUS group were higher than those in the NWUS group.We included atrial fibrillation and low density lipoprotein in Binary Logistic Regression Analysis and found that patients with a history of atrial fibrillation(Odds Ratio,OR 2.769;95% Confidence Interval,CI: 1.185-6.474;P = 0.019)had a 2.769 times higher risk of WUS than NWUS.Compared with non-wake-up stroke,LDL(OR 1.493;95% CI: 1.082-2.058;P = 0.015)increased,susceptible to wake-up stroke.Conclusion:(1)Compared with non-awake stroke,patients with atrial fibrillation and high LDL were more likely to have wake-up stroke.(2)There was no significant difference in the age,hypertension and diabetes between the WUS group and the NWUS group.(3)There was no significant difference in 24 hours,diurnal and nocturnal blood pressure variability between the two groups.