The Clinical Research Of Pathogenesis Mechanisms And Risk Factors Of Deterioration Of Neurological Function In Acute Cerebral Infarction

Objective:To investigate the pathogenesis mechanisms and risk factors of the deterioration of neurological function in acute cerebral infarction.Methods:30 patients with acute cerebral infarction which had deterioration of neurological function after admission acted as deterioration of neurological function in acute cerebral infarction group(A group),and selected 30 patients matched with them who had no deterioration of neurological function in acute cerebral infarction which hospitalized in the same period acted as no deterioration of neurological function group(B group).To statistical analysis with general information, biochemical and head CT changes on two groups of patients and to compare the differences between the two groups.Result:1,General Information:Single-factor analysis showed that comparing with history of diabetes,history of hypertension,admission systolic and diastolic blood pressure levels,NIHSS score,there was a significant difference between the two groups(P＜0.05).Comparing with gender,age,smoking history,history of stroke, There was no difference between the two groups(P＞0.05).2,Biochemical examination:comparing with fasting blood glucose,fibrinogen,serum ferritin, high-sensitivity C-reactive protein,there was a significant difference between the two groups(P＜0.01).There was no significant difference between the two groups in other biochemical parameters.3,Head CT changes:The positive rates of CT which fall ill within 24 hours were 46.7%(A group) and 6.7%(B group).There was a significant difference between the two groups(P＜0.01).4,The results of multiple stepwise regression analysis showed that there was a positive correlation between serum ferritin concentration and high-sensitivity C-reactive protein concentration and fibrinogen,The increased serum ferritin concentration was an independent risk factor of deterioration of neurological function in acute cerebral infarction.Conclusion:1.Deterioration of neurological function in acute cerebral infarction is related to a variety of mechanisms and multiple risk factors.2.The pathogenesis mechanisms of the deterioration of neurological function in acute cerebral infarction could be due to:①Lower blood pressure,lower cerebral perfusion pressure and the enlargement of ischemic penumbra;②The nerve cell death and / or apoptosis which leaded by the increased inflammatory response and cytotoxic response.3.History of hypertension,history of diabetes,the blood glucose,fibrinogen,serum ferritin concentration and high-sensitivity C-reactive protein concentration increased in the incidence could be the risk factors of deterioration of neurological function in acute cerebral infarction.4.Early CT abnormalities have predictive value to deterioration of neurological function in acute cerebral infarction.5.Neurological deficit score on behalf of the extent of neurological damage after admission,it is the forecast indicators of deterioration of neurological function in acute cerebral infarction. 6.There are linear regression relationship and are positively correlated between serum ferritin concentration and high-sensitivity C-reactive protein concentration and fibrinogen.The serum ferritin concentration is an independent risk factor of deterioration of neurological function in acute cerebral infarction and have predictive value to it.