| ObjectivesTo analyze the relationship between plasma PTH levels and the onset of ischemic stroke, and to study the relationship between plasma PTH levels and the severity and prognosis of ischemic stroke.MethodsPatients with acute ischemic stroke who met the diagnostic requirements of the guideline and confirmed by cranial CT or MRI at the First Affiliated Hospital of Xi'an Medical College from April,2018 to October,2018,and the incidence was less than after 24 hours,according to the exclusion criteria to exclude the unqualified and dead cases,a total of 79 cases were included as case groups.In addition,65 patients with concurrent or healthy examinations were included in the exclusion criteria,and ischemic stroke was excluded.The general condition,past medical history,and blood related examinations of the case group and the control group were collected.In the case group,the neurological deficit score was scored according to the NHISS rating scale.The scores were divided into mild,moderate,and severe groups according to less than 4 points,4 to 15 points,and greater than 15 points.According to the infarct size greater than 3cm~2,between 1.5-3cm~2,less than 1.5 cm~2,divided into large area cerebral infarction(severe),small area cerebral infarction(moderate),lacunar infarction(mild),in order to assess the seriousness of the case group when admitted to hospital?Finally,the improved Rankin scale(mRS)was evaluated after the onset of the disease in the case group.The scores were good(0-1 points),medium(2-3 points),and poor(4-5 points).Three levels are used to determine the prognosis of the patient.Finally,statistical data processing was performed to analyze the relationship between PTH levels and ischemic stroke.Results(1)Comparison of blood PTH levels between case group and control group:The blood PTH level of case group was 12.00±3.74pg/mL,which was significantly higher than that of control group 10.40±4.25pg/mL,the difference was statistically significant(P<0.05).(2)Using gender,history of hypertension,systolic blood pressure,diastolic blood pressure,white blood cell count,TG,PTH,VD,IL-6 and other meaningful items as covariates,whether or not ischemic stroke as a dependent variable for binary logistic regression Analysis,the results showed that blood PTH level B=-0.130,OR=0.878,P=0.012;the results were statistically significant(P<0.05);(3)Comparison of blood PTH levels in patients with different cerebral infarction areas:35patients with mild cerebral infarction(less than 1.5 cm~2),33 patients with moderate cerebral infarction(between 1.5-3 cm~2),severe cerebral infarction 21 patients(greater than 3cm~2);the difference of blood PTH(F=11.163)between patients with different size of cerebral infarction area was statistically significant(P=0.000<0.05).(4)Comparison of blood PTH levels in patients with different NIHSS scores:36 patients with mild(less than 4 points),34 patients with moderate(between 4 and 15),and severe(more than 15 points)according to the NIHSS score.There were no significant differences in blood PTH levels(F=0.355)between the 9 groups of patients with different NIHSS scores(P=0.702>0.05).(5)Comparison of blood PTH in patients with different mRS scores after 1 month of onset showed that:the follow-up evaluation of mRS scores in the case group after 1 month of onset according to the scores divided the prognosis into good(0-1 points)35 cases,medium(2-3points)27 cases There were 17 cases of poor(4-5 points),and the difference of blood PTH(F=6.53)between the patients with different mRS scores after 1 month of onset was statistically significant(P=0.002<0.05).Conclusions(1)Blood PTH level is significantly associated with the onset of ischemic stroke,which is an independent risk factor for ischemic stroke,playing a role in the prevention and prediction of ischemic stroke;(2)The blood PTH level can reflect the severity and prognosis of patients with ischemic stroke to a certain extent.The higher the blood PTH level,the more severe the condition and the worse the prognosis. |
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