| Objective: This study was conducted to investigate the correlation between kidney deficiency and marrow deficiency and the degree of recovery of motor dysfunction after stroke and its possible influencing factors,and to provide clinical support for the prognosis assessment and treatment of motor dysfunction by evaluating the motor function of ischemic stroke patients in the acute and recovery periods and observing the relevant serum index levels.Methods: In this study,97 cases meeting the criteria were included in a prospective cohort study,and were divided into a kidney deficiency and marrow deficiency group(49 cases)and a non-kidney deficiency and marrow deficiency group(48 cases)according to whether they met the evidence of kidney deficiency and marrow deficiency.Patients in both groups were treated with conventional internal medicine basic treatment.General information such as age,gender,history of smoking and alcohol consumption,and past medical history were collated separately;m RS score,NIHSS score,and modified Ashworth score were recorded on day 1,14 days,and 90 days of admission;Fazekas score on day 1 of admission;number of patients in Brunnstrom stage I on day 1 of admission in both groups,and observation of patients in stage I within 14 days of admission The frequency of symptoms related to kidney deficiency and marrow deficiency was recorded.The effect of renal deficiency on the NIHSS score,m RS score and modified Ashworth score in patients with motor dysfunction in ischemic stroke was analyzed by logistic regression;the difference of Fazekas score at day 1 of admission was compared between the two groups;the levels of serological indexes at days 0,14 and 90,and the levels of serum BDNF at days 0 and 90 were compared between the groups.SPSS25.0 statistical software was selected to analyze the data in this study: data that met normal distribution and satisfied chisquaredness were analyzed by independent sample t-test,and data that did not meet normal distribution or chi-squaredness were analyzed by MannWhitney U test;the chi-squared test was used for counting data;logistic regression analysis was used for correlation analysis.Results: General data: A total of 97 cases meeting the requirements were completed in both groups,including 49 cases in the kidney deficiency and marrow deficiency group and 48 cases in the non-kidney deficiency and marrow deficiency group.There were no significant differences between the two groups in all aspects such as gender,age,history of smoking and alcohol consumption,and past history,with good comparability(P>0.05).Functional scores: there was no statistical difference in the comparison of NIHSS scores,m RS scores,and modified Ashworth scores between the two groups at day 1 of enrollment(P>0.05);regression analysis showed that renal deficiency and medullary deficiency were factors associated with changes in m RS scores at 14 and 90 days of enrollment(P<0.001,OR=8.409,95% CI=3.368-20.995;P<0.001,OR=1.675,95% CI=3.035-26.440);renal deficiency and medullary deficiency were correlates of change in modified Ashworth score at 14 and 90 days of enrollment: change in Ashworth score at 14 and 90 days of enrollment was correlated with renal deficiency and medullary deficiency(P<0.001,OR=5.623,95% CI=2.333-13.551;P<0.001,OR=23.684,95% CI=6.440-87.108);there was no statistically significant correlation between the change in NIHSS score and kidney deficiency and marrow deficiency at 14 days and 90 days of enrollment(P>0.05,OR=1.675,95%CI=0.720-3.894;P>0.05,OR=2.206,95%CI=0.891-5.465).Analysis of symptoms of kidney deficiency and marrow deficiency:dizziness and headache in 35 cases(71.4%),insomnia and forgetfulness in34 cases(69.4%),back and leg pain in 33 cases(67.3%),slowness of movement in 32 cases(65.3%),haggard teeth in 28 cases(57.1%),fatigue in 26 cases(53.1%),slowness of movement in 22 cases(44.9%),dullness of reaction in 20 cases(40.8%),haggard hair and tinnitus in 18 cases(36.7%),deafness and tinnitus in 13 cases(26.5%),abnormal urination in11 cases(22.4%),and dizziness and tinnitus in 11 cases(22.4%).There were 20 cases(40.8%)of unresponsiveness,18 cases(36.7%)of dull hair,13 cases(26.5%)of deafness and tinnitus,11 cases(22.4%)of abnormal urination,and 9 cases(18.4%)of night sweating.Serological indices: there was no statistically significant difference in serum LDL levels between the two groups at day 1,14 days and 90 days of enrollment,respectively(P>0.05);there was a statistically significant difference in blood homocysteine levels between the two groups at day 14 of enrollment(P<0.05),and no statistically significant difference at day 1 and 90 of enrollment(P>0.05);prothrombin time(PT),activated partial thromboplastin time(APTT),prothrombin time(TT),fibrinogen(FIB),and D-dimer were not statistically significant when compared between the two groups at 0,14,and 90 days of enrollment(P>0.05);the serum BDNF levels were different between the two groups at 0 and 90 days of enrollment(P<0.05);and the kidney deficiency and marrow There was also a statistically significant difference in serum BDNF levels in the kidney deficiency group on day 1compared with day 90(P<0.05),while there was no statistically significant difference in the non-kidney deficiency group at different time points(day 1 and day 90)(P>0.05).Conclusions: 1.Compared with non-kidney deficiency and marrow deficiency,the recovery of motor function in patients with kidney deficiency and marrow deficiency in ischemic stroke is relatively slow,suggesting that kidney deficiency and marrow deficiency may be an important pathogenic mechanism for the impaired recovery of motor function in ischemic stroke;2.Brain white matter lesions and low serum BDNF levels may be factors affecting the impaired recovery of motor function in patients with kidney deficiency and marrow deficiency. |
