| Background Ischemic cerebral apoplexy is a kind of cerebrovascular disease characterized by local brain tissue malacia or ischemic necrosis.The blood circulation of the brain caused by arterial occlusion or stenosis causes hypoxia and ischemia in the brain.Ischemic stroke has the characteristics of high morbidity,high recurrence rate and high mortality.Therefore,ischemic stroke has seriously affected the public health construction and national health level.Patients with ischemic stroke had a higher risk of Early Neurological Deterioration(END),which severely affects short-term function and hospital mortality.Most of the END is defined as an increasing of NIHSS score≥2 in the first 72 hours after admission in most of recent study.Therefore,prevention and reduction of END were beneficial to improve the prognosis of patients,and have important clinical and social significance.However,there were currently few studies on END risk factors,and the preventive measures for END were still limited.Objective The risk factors of END in patients with acute ischemic stroke were deeply analyzed,for ensure and improve the quality of life of patients with acute ischemic stroke,and providing a more scientific,effective and comprehensive basis for the prevention,control and treatment of stroke diseases.Methods The clinical data of 326 patients with ischemic stroke who were treated in yuzhou people’s hospital were collected from January 2015 to December 2017.Patients with neurological deterioration within 72 hours after admission were selected as the END group.Meanwhile,general data(age,gender,BMI,etc.)of the same number of patients who did not experience general neurological deterioration and matched the END group were selected as the non-END group.The t-test was used to compare the biochemical parameters such as age,gender,blood pressure,NIHSS score,total cholesterol,triglyceride,high/low density lipoprotein cholesterol,fasting blood glucose,fibrinogen and C-reactive protein,and anterior cerebral artery A1/A2,middle cerebral artery M1/M2/M3,posterior cerebral artery P1/P2,common carotid artery,internal carotid artery,vertebral artery,innominate artery,subclavian artery,basilar artery and other arterial CAS values.Theχ~2 test was used to compare the drinking history,smoking history,family history of stroke,and other past medical history,and the changes of head CT in the two groups.Baseline data,biochemical analysis indexes,CT changes and the relationship between arterial CAs and end were analyzed.Results (1)Within 72 h after admission,326 cases of acute ischemic stroke had 58 cases of early neurological deterioration,accounting for 17.79%,the median value of 0～26 h(19～62 h)from the onset time was aggravated by 26 cases(44.83%)in 24 h,the condition was aggravated in 48 cases(82.76%),and 58 cases(100%)were aggravated in the period H.(2)the NIHSS score,systolic blood pressure,diastolic blood pressure,and fever number in the END group were higher than the non-END group(P<0.05).(3)The serum CRP level in the END group was higher the non-END group(P<0.05).(4)There was no significant difference between END group and non-END combined with arrhythmia and bradycardia(P>0.05).(5)The degree of vascular stenosis in the END group was more moderately severeth than the non-END group,(P>0.05).(6)The CAS score of the END group was higher the non-END group(P<0.05).(7)The mortality rate in the end group was 5.17%,the mortality rate in the non-end group was 6.90%,there was no statistically difference(P>0.05).(8)Multivariate logistic regression analysis showed that baseline NIHSS scores,severely responsible stenosis,and CAS scores were independent predictors of END.Conclusion The risk of END in patients with ischemic stroke is higher,and the occurrence of end in patients with ischemic stroke is affected by a variety of mechanisms or factors,Patients with baseline NIHSS scores,incidence of severe vascular stenosis,and CAS scores were independent predictors of END onset. |
