The Clinical Case-control Study On The Relative Factors Of The Cerebral Progressive Ischemic Stroke

ObjectiveDiscuss the important risk factors which significantly impact the ischemic stroke’sprogression through the clinical case-control study on the relative factors of the cerebralprogressive ischemic stroke,thus provide a strong evidence for the prediction on heischemic stroke’s progression.Method1.Select all the patients who were diagnosed cerebral ischemic stroke and checkedinto our hospital between a specific period of time for treatment,divide them into twogroups:progressive(64cases) group and non-progressive (181cases) group.And count upretrospectively the basic information of all the patients,including gender,age,bloodfat,blood sugar(BS),blood pressure(BP),homocysteine(HCY) and different levels of culpritvessel s’stenosis or block,also including the condition of normal vessels;2.Conduct two independent sample t-test on the ages from different groups;3.Conduct Fisher’s chi-square test on the indexes as gender,blood fat,bloodsugar(BS),blood pressure(BP) and homocysteine(HCY);4.Conduct multiple comparison among multiple sample rates on different levels ofculprit vessel s’stenosis or block(including the condition of normal vessels);5.At last,we conduct the Logistic regression analysis on the indexes which existdifferences statistically between the two groups.Result1.There are21patients(32.8%) who is hyperglycemia in progressive group;and30patients(16.6%) who is hyperglycemia in non-progressive group;compare the indexefrom the two groups,P<0.05.We can think that there are significant statistic differences of the levels of blood sugar between the two groups;2.The mean age of patients in progressive group is (60.58±11.313),and the mean ageof patients in non-progressive group is (58.79±10.042),compare the ages from differentgroups,we found that P>0.05,so we can not think that there are significant statisticdifferences between ages from the two groups; There are41male patients(64.1%)，16patients(25%) with hyperhomocysteinemia(HHCY)，50patients(78.1%) with high blo-od pressure，25patients(39.1%)with hyperlipidemia in progressive group,and128malepatients(70.7%)，55patients(30.3%) with hyperhomocysteinemia(HHCY)，132patients(72.9%) with high blood pressure，57patients(31.5%)with hyperlipidemia in non-progressive group;Compare the indexes between the two groups.similarly,P>0.05,we couldn’teither think that there are significant statistic differences between these indexes from thetwo groups;3.There are25patients without culprit vessels’ stenosis or block,4patients with mildculprit vessels’ stenosis,9patients with moderate culprit vessel s’ stenosis,26patients withsevere culprit vessels’ stenosis or block in progressive group;and there are125patientswithout culprit vessels’ stenosis or block,10patients with mild culprit vessels’ stenosis,19patients with moderate culprit vessels’ stenosis,27patients with severe culprit vessels’stenosis or block in progressive group; made the patients without culprit vessels’ stenosisor block as a control group,compare the rates of progressive stroke separately withmild,moderate,and severe culprit vessels’ stenosis or block groups.In the comparison withsevere culprit vessels’ stenosis or block groups,P<0.008,so we can think that severe culpritvessels’ stenosis or block can make a difference between progressive and non-progressivestroke; While in the comparison with mild and moderate culprit vessels’ stenosis or blockgroups,P>0.008,so we can not think that mild or moderate culprit vessels’ stenosis or blockmade a difference between progressive and non-progressive stroke.4.Only the two indexes: hyperglycemia and severe stenosis of culprit vessels comeinto the logistic regression equation,and both of their P>1. So we can think thathyperglycemia and severe stenosis of culprit vessels influent the progression of thecerebral ischemic stroke significantly, and both the two indexes are negative factors.Conclusion1.There are not significant relativity between gender,age,Hyper lipidemia,high bloodpressure,hyperhomocysteine(HHCY) and the prog ression of cerebral ischemic stroke.2.The high level of blood sugar and the different levels of culprit vessel s’stenosis orblock are relative with the progression of cer ebral ischemic stroke;and the two indexes: hyperglycemia and severe stenosis of culprit vessels can significantly impact theprogression of the cerebral ischemic stroke,as the important risk factor of the progressiveischemic stroke.Meanings1.This research support that the hyperglycemia is the important risk factor of theprogressive ischemic stroke,which coincide with most of researches on the relationshipbetween the blood sugar and the progressive ischemic stroke. Thus confirmed the adverseeffect on the progressive ischemic stroke,and provide a strong theoretical basis for clinicactive hypoglycemic therapy in order to reduce the incidence of the cerebral ischemicstroke’s progression.2.In this research,the vessels we count up are culprit vessels of new hairinfarcts,which were not found in so many researches earlier,thus the main innovative pointin the research. At the same time, the severe stenosis or block of the culprit vessels also isthe important risk factor of the progressive ischemic stroke.This conclusion also promptthat:we have reason to intervene the intracranial and extracranial severe stenosis or blockactively as well as it is detected,no matter by drugs or by intervention means.