Analysis On Risks Of The Initial And Recurrent Cerebral Ischemic Stroke In Young And Middle-aged Adults

Objective:To explore including serum uric acid（UA）,white blood cells（WBC）,fasting plasma glucose（FPG）,cystatin C（Cys-C）,and other related risk factors and ischemic stroke（IS）in young and middle-aged adults of recurrence and severity of illness degree relations,and further analyzes its predictive effect on recurrence.Methods:Through collecting hospitalized patients of young and middle-aged ischemic stroke in Handan First Hospital from September 2017 to July 2019 and dividing patients into the first diagnosed IS group and the recurrent IS group according to whether there was recurrence within 1 year.General information of patients including gender,age,life history,family history of Stroke,history,National Institutes of Health Stroke Scale（NIHSS）score were compared between the two groups for the first-time hospitalization.Imaging data included the location of the disease,white matter loose,cerebral micro-hemorrhage,and intracranial and extracranial large vessels.Laboratory indicators included serum uric acid,white blood cells,fasting plasma glucose,cystatin C,high-density lipoprotein,low-density lipoprotein,total cholesterol,triglycerides,hypersensitive C-reactive protein,and homocysteine.Univariate analysis was used to analyze the distribution of the above indicators between the two groups,and the risk factors of IS recurrence in young and middle-aged people were analyzed by multivariate logistic regression analysis.The correlation between UA,WBC,FPG,Cys-C,and NIHSS score was analyzed with Pearson correlation,and the Receiver Operator Characteristic（ROC）curve of UA,WBC,FPG and Cys-C was plotted to analyze its application value to the clinical recurrence events of IS in young and middle-aged people.Results:（1）A total of 267 patients were included,of which 215 cases（80.5%）were the first diagnosed group,and 52 cases（19.5%）were the recurrent group;Univariate analysis showed that there were differences in UA,WBC,FPG,Cys-C,NIHSS score,migraine,cerebral micro-hemorrhage,white matter lose,and hypertension between the two groups（P<0.05）.（2）Multivariate logistic regression analysis showed that UA（OR:1.011,95%CI 1.003-1.018,P=0.005）,WBC（OR:1.262,95%CI 1.006-1.584,P=0.045）,FPG（OR:1.315,95%CI 1.021-1.692,P=0.034）and Cys-C（OR:6.586,95%CI 1.072-40.457,P=0.042）were independent risk factors for the recurrence of IS in young and middle-aged adults（P<0.05）.（3）UA,WBC,FPG and Cys-C were positively correlated with NIHSS scores,and the correlation coefficients R were 0.449,0.520,0.492 and 0.598,respectively（P<0.05）.The areas under the ROC curve were 0.711,0.772,0.677 and 0.746,respectively,and the critical values were 344umol/L,7.525/10⁹L^-1,7.36mmol/L and 1.005mg/L.Conclusions:（1）Blood UA,WBC,FPG,and Cys-C were independent risk factors for IS recurrence in young and middle-aged adults and were positively correlated with IS recurrence in young and middle-aged adults.（2）Blood UA,WBC,FPG,and Cys-C were positively correlated with the degree of neurological impairment in young and middle-aged patients with ischemic stroke.（3）Blood UA,WBC,FPG,and Cys-C were predictors of IS recurrence in young and middle-aged adults.When UA was>344umol/L,the risk of recurrence was increased.When WBC was>7.525/10⁹L^-1,the risk of recurrence was increased.When FPG was>7.36mmol/L,the risk of recurrence increased.When Cys-C was>1.005mg/L,the risk of recurrence was increased.