Discussion On Related Prognosis Factors Influencing Stroke In Progression

Objectives: To study related clinical factors that have affected the prognostic stroke in progression(SIP) and to provide some clinical evidences for prevention of stroke in progression clinically. Methods: This study adopted the retrospective grouping case analysis and enrolled 117 patients with SIP who had been admitted into the Neurology of 2nd Affiliated Hospital, Fujian Medical University between January 2011 and December 2014. The standardized treatment was carried out according to the China guide(2010 edition) of diagnosis and treatment of ischemic stroke. Those patients were telephone followed up for three months at outpatient and then divided into two groups based on modified Rankin score and prognostic conditions after three months: ①mRS≤2 as favorable prognosis group;②mRS≥3 as the poor prognosis group. The differences of past history(medical history of hypertension, diabetes and coronary heart disease; history of smoking and drinking), NIHSS score, blood pressure, blood pressure declines, body temperature, fasting blood-glucose, D-dimer, fibrinogen, hypersensitive C-reactive protein, head and neck CTA and so forth were analyzed between groups. Results: After follow ups, there 61 patients(52.1%) had favorable prognosis and 56(47.9%) of poor prognosis among 117 patients with SIP. Statistical analysis showed that the medical history of diabetes(29.5%:57.1%,P=0.003), NIHSS score(4.89±1.93:6.68±2.68,P=0.000), body temperature(16.4%:39.3%,P=0.006), systolic pressure(167.79±28.47:177.54±19.55,P=0.034), blood pressure declines(18.0%:42.9%,P=0.003), fasting blood-glucose(7.21±1.85:8.08±2.20,P=0.023), D-dimer(1.55±0.49:1.76±0.44,P=0.017), fibrinogen(3.89±0.77:4.33±1.06,P=0.012), hypersensitive C-reactive protein(7.21±2.45:8.76±4.03,P=0.013), intracranial and extracranial main artery plaques( 73.8%:89.3%,P=0.032) and intracranial and extracranial main artery stenosis rate(19.7%:51.8%,P=0.000) had significant differences. It has the statistical significance(P<0.05). Further logistic regression analysis suggested that those factors including blood pressure declines, fever, diabetes, hyperfibrinogenemia, D-dimer increases, C-reactive protein increases, and intracranial and extracranial main artery stenosis rate>50% might impact the SIP prognosis. Conclusions: There are approximately half SIP with poor prognosis and factors of aggravated neurologic function, blood pressure declines, fever, diabetes, hyperfibrinogenemia, D-dimer increases, C-reactive protein increases, and intracranial and extracranial main artery stenosis rate>50% may impact the SIP prognosis.