| Object To explore the relationship between subtypes of five cerebral infarction typingsand PIS. Establish different combinations composed of related subtypes of PIS, thencompare each other and obtain the most excellent combination that suggest progressiveischemic stroke, Offer theoretic evidence for the prevention and treatment of PIS.Methods407patients with acute cerebral infarction confirmed by Magnetic ResonanceImaging were divided into two groups: PIS group(n=106) and non-progressing group(n=301).TOAST typing, OCSP typing, CT typing, CISS typing and ASCO typing wereall performed as soon as they are in hospital. At the same time age, gender, smoking,alcohol, the history of hypertension, the history of stroke, the history of coronary heartdisease, the history of diabetes were collected. These factors were compared betweenprogressing group and non-progressing group by univariate analysis, then risk factorsrelated PIS were obtained. The significant factors which were analyzed by multivariatelogistic regression (LR forward) analysis composed different combinations. Thecombinations were checked from those perspectives: facticity, predictive effect ofdiagnostic test and the goodness of fit between the combinations and the original sample.At last,81patients checked the most excellent combination.Result1Chi-square Tests showed that significant differences about the history ofhypertension, history of diabetes, LAA subtype and SAO subtype(TOAST typing), TACIsubtype, PACI subtype, POCI subtype and LACI subtype (OCSP typing), Large fractiongroup, middle fraction group and lacunar infarction group(CT typing), LAA subtype,PAD subtype and UE subtype(CISS typing) and A subtype and S subtype(ASCO typing)existed in two groups (P<0.05); Gender, age, smoking, alcohol, the history of stroke, thehistory of coronary heart disease and other subtypes of cerebral infarction typings did notexist significant differences(P>0.05), The outcome of multivariate by non-conditionalLogistic(Forward LR) analysis regression: History of diabetes, TACI subtype and PACIsubtype(OCSP typing), Large fraction group and lacunar infarction group (CT typing)and UE subtype(CISS typing) existed significant difference between two groups. The riskof progressive stroke occurring in these cerebral infarction groups were respectively:OR=4.097, OR=7.552, OR=10.428, OR=2.969, OR=0.296, OR=0.225;2Analyze those factors: the history of diabetes, TACI subtype and PACI subtype (OCSP typing), largefraction subtype and lacunar infarction subtype(CT typing) and UE subtype (CISS typing)by multivariate logistic regression (LR forward) analysis. the factor with the biggest ORvalue was introduced into the combination, Orderly, one factor was not introduced intocombination and the combination did not remove the factor. Establish the differentcombinations. Evaluate combinations from those perspectives: facticity, predictive effectof diagnostic test, and the goodness of fit between the combination and the originalsample; Last, the result showed that combination⑤[sensitivity (0.717), specificity(0.841), Youden’s index(0.558), Kappa value (0.528), positive predictive value(0.613),negative predictive value(0.894)] was more excellent than other combinations;3Thecombination⑤were tested by81patients, the result showed the sensitivity (0.810),specificity (0.833), accuracy(0.827), Kappa value (0.588).Conclusions1the history of hypertension, the history of diabetes, LAA subtype andSAO subtype (TOAST typing), TACI subtype, PACI subtype, POCI subtype and LACIsubtype(OCSP typing), Large fraction group, middle fraction group and lacunarinfarction group (CT typing), LAA subtype, PAD subtype and UE subtype (CISS typing)and A subtype and S subtype (ASCO typing) were related to PIS;2The factors aboutthe history of diabetes, TACI subtype and PACI subtype (OCSP typing), lacunarinfarction group(CT typing) and UE subtype(CISS typing) were the best combination. Itimproved the accuracy of prediction about PIS. |
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