Clinical Features And Prognosis Of Patients With Cerebral Infarction Complicated With Autoimmune Diseases

Objective: To explore the clinical features and prognosis of patients with cerebral infarction complicated with Autoimmune Diseases(AD).Methods: A total of 184 patients with cerebral infarction with autoimmune diseases admitted to our hospital from July 2009 to December 2017 were enrolled and patients with atherosclerotic cerebral infarction matched with their gender and age were collected as control group.Analysis of the clinical features and prognosis of both.According to the number of cases associated with autoimmune diseases and the number of cases,the patients were divided into three subgroups A(Thyroid disease,n=90),B(Rheumatoid Arthritis group,n = 47)and C(other autoimmune disease groups,including Psoriasis,systemic Lupus erythematosus(SLE),multiple sclerosis,Sjogren's syndrome,vasculitis,polymyositis,n = 47)for comparison.Logistic regression analysis was used to analyze predictors of stroke.Results: Compared with patients with Large artery atherosclerosis(LAA)cerebral infarction,patients with autoimmune diseases were found to have significant differences except for atrial fibrillation(P<0.01),hypertension(P<0.01),diabetes(P<0.05)and smoking history(P<0.01),and its fasting blood glucose(P<0.05),FT3(P<0.01),LDL(P<0.01)and CHOL(P<0.01)values were significantly higher than those of the control group Low,and TPO(P<0.01),TGAB(P<0.01),CRP(P<0.05),hospitalization cycle(P<0.05),mRS(P<0.05)scores were significantly higher than the control group.There were significant differences in age(P<0.01)?TOAST Subtype(P<0.01)?TSH(P<0.05)?ESR(P<0.01)?CRP(P<0.01)?Hospitalization cycle(P<0.05)?NIHSS after discharge(P<0.01)and mRS(P<0.01)among the three groups.Intergroup analysis found: There were significant differences in age(64.67±15.55 VS 70.53±9.73,P<0.05)?TSH(12.35±23.01 VS 2.17±1.44,P<0.01)?ESR(14.00±9.67 VS 44.67±27.22,P<0.01)?CRP(9.71±11.86 VS 50.00±77.71,P<0.01)?Hospitalization cycle(8.20±3.76 VS 10.87±6.31,P<0.05)? and mRS(1.73±1.58 VS 3.34±1.87,P<0.01)in group A and B.There was significant difference in TSH(12.35±23.01 VS 2.24±2.05,P<0.01)?Hospitalization cycle(8.20±3.76 VS 10.53±5.13,P<0.05)between group A and group C.There was significant difference in TSH(2.17±1.44 VS 2.24±2.05,P<0.05)?CRP(50.00±77.71 VS 12.86±22.90,P<0.05)?mRS(3.34±1.87 VS 2.15±1.97,P<0.01)between group B and group C.Factors that are closely related to neurological recovery are age,CRP,specific disease type associated with discharge,and NIHSS score.Conclusion: Compared with patients with large atherosclerotic cerebral infarction,the traditional vascular risk factors such as atrial fibrillation,hypertension,and diabetes are less frequent in cerebral infarction patients with autoimmune diseases.The indexes of blood glucose and lipid metabolism in patients with cerebral infarction complicated with autoimmune diseases were significantly reduced,while the inflammation-related indexes such as TPO,TGAb,and CRP were significantly increased.However,the hospitalization period is long and the prognosis of neurological function is poor.Neurological deficits in patients with cerebral infarction complicated with thyroid diseases are relatively mild and the prognosis is good.Patients with RA have impaired neurological function and the worst prognosis.The age,CRP,type of concomitant disease,and the degree of neurological deficit in hospital discharge are closely related to the long-term prognosis of patients with cerebral infarction.