| Obiective: To investigate the risk factors and TCM constitution types of patients with wake-up ischemic stroke by investigating the relevant clinical data and TCM constitution,and to provide preliminary hints as well as related references for the prevention and treatment of wake-up ischemic stroke.Methods: Patients with acute cerebral infarction who were hospitalized from January2018 to June 2019 in the Department of Neurology,Affiliated Hospital of Inner Mongolia University for the Nationalities were continuously collected.They were divided into wake-up ischemic stroke group and non-wake-up ischemic stroke group according to the time of occurrence of cerebral infarction.Compare the general conditions,risk factors,laboratory tests,TOAST subtypes,distribution of aortic atherosclerotic ischemic stroke,NIHSS score scale and TCM physical fitness scale of the two groups of patients,and analyze the risk factors and TCM constitution types.Results: A total of 218 patients were collected in this study,including 55 patients in the wake-up ischemic stroke group,accounting for 25.2%,and 163 patients in the non-wake-up ischemic stroke group,accounting for 74.8%.? Analysis of clinical data:1 Single factor analysis shows:a General situation: There was no significant difference in age,gender,body mass index,systolic blood pressure at admission,diastolic blood pressure at admission,and NIHSS scores between the two groups.b Risk factors:39 patients(70.9%)had hypertension in the wake-up ischemic stroke group and 142(87.1%)in the non-wake-up ischemic stroke group.Compared with the two groups,the number of patients with hypertension in the non-wake-up ischemic stroke group was significantly higher in the wake-up ischemic stroke group(P <0.01);There were 32 people(58.2%)with hyperhomocysteinemia in the wake-up ischemic stroke group,and 48 people(29.4%)in the non-wake-up ischemic stroke group.The number of patients with hyperhomocysteinemia was significantly higher than that in non-wake-up ischemic stroke group(P <0.01);There were 18 people(32.7%)with hyperuricemia in the wake-up ischemic stroke group and 27 people(16.6%)in the non-wake-up ischemic stroke group.Compared with the two groups,the number of hyperuricemia in the wake-up ischemic stroke group was higher In the non-wake-up ischemic stroke group(P <0.05);There was no significant difference in diabetes,hyperlipidemia,coronary heart disease,atrial fibrillation,and smoking history between the two groups.c Laboratory test:The homocysteine in wake-up ischemic stroke group is 17.00(13.10,29.90)?mol / L and in non-wake-up ischemic stroke group is 14.20(11.40,19.90)?mol / L.compared between the two groups,the level of homocysteine in the wake-up ischemic stroke group was higher than that in the non-wake-up ischemic stroke group(P <0.05);The fasting blood glucose,glycated hemoglobin,triglyceride,total cholesterol,low-density lipoprotein,high-density lipoprotein,blood creatinine,blood uric acid,and serum albumin levels were not statistically significant between the two groups.d TOAST subtypes: There was no statistically significant difference in the distribution of TOAST subtypes between the two groups.e Distribution of aortic atherosclerotic ischemic stroke: There were 42 patients(76.4%)of aortic atherosclerotic ischemic stroke in the wake-up ischemic stroke group and 80 patients(49.1%)in the non-wake-up ischemic stroke group.Compared with the two groups,the number of aortic atherosclerotic ischemic stroke in the wake-up ischemic stroke group was significantly higher than that in the non-wake-up ischemic stroke group(P <0.01).f Age classification: There is no statistically significant difference in the distribution of the two groups of patients in each age group.g Neurological function classification: There is no statistically significant difference in the distribution of neurological function between the two groups.h Alcohol consumption classification: There was no statistically significant difference in the distribution of alcohol consumption levels between the two groups of patients.i Grading of hypertension: In the wake-up ischemic stroke group,there were 16 patients(29.1%)who did not suffer from hypertension,4 patients(7.3%)had grade 1 hypertension,7 patients(12.7%)had grade 2 hypertension,28 patients(50.9%)had grade 3 hypertension.In the non-wake-up ischemic stroke group,there were 21 patients(12.9%)had no hypertension,5 patients(3.1%)had grade 1 hypertension,23 patients(14.1%)had grade 2hypertension,114 patients(69.9%)had grade 3 hypertension.There were differences in the distribution of hypertension between the two groups(P <0.05).j Hyperlipidemia classification: There was no statistically significant difference in the distribution of hyperlipidemia types between the two groups.2 Multi-factor Logistic regression analysis shows:Hypertension(OR=0.324,95%CI0.145?0.726,P<0.01),hyperhomocysteinemia(OR=2.548,95 % CI1.296 ? 5.008,P < 0.01),aortic atherosclerosis Sclerosing stroke(OR=2.742,95%CI1.321?5.692,P<0.01)were significant factor.Diabetes,hyperlipidemia,coronary heart disease,atrial fibrillation,hyperuricemia,gender,and smoking history were insignificant factors and were excluded.?.TCM constitution types: TCM constitutions types of patients in the wake-up ischemic stroke group are as follows: 13 patients with phlegm and dampness(23.6%),10 patients with yang deficiency(18.2%),and 8 patients with damp heat(14.5 %),6 patients with yin deficiency(10.9%),5 patients with qi deficiency(9.1%),5 patients with blood stasis(9.1%),4 patients with qi depression(7.3%),3 patients with calm quality(5.5%),1 patient with endemic(1.8%).In the non-wake-up ischemic stroke group,there were 36 patients with phlegm and dampness(22.1%),27 patients with yin deficiency(16.6%),22 patients with qi deficiency(13.5%),16 patients with yang deficiency(9.8%),16 patients with hot and humid(9.8%),14 patients with blood stasis(8.6%),13 patients with qi-depressed(8.0%),13 patients with qualitative(8.0%),and 6 people patients with mild(3.7%).there was no statistically significant difference in the distribution of TCM constitution types between the two groups.Conclusion: Our research shows that: 1 Patients with hypertension may be more prone to non-wake-up ischemic stroke,and hyperhomocysteinemia and aortic atherosclerosis may be more closely related to wake-up ischemic stroke;Although there is no statistically significant difference in the distribution of TCM constitution types between the two groups of patients,the sputum dampness,yang deficiency and dampness-heat quality were more in the wake-up ischemic stroke group,and the phlegm dampness,yin deficiency and qi deficiency were more in the non-wake-up ischemic stroke group. |
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