| Background and PurposeStroke is a group of diseases characterized by cerebral ischemia and hemorrhagic injury.It is characterized by high mortality and disability.progressive ischemic stroke,also known as early neurological deterioration,is one of the most particularly dangerous.There is no standardized guideline for the definition and diagnosis of PIS.According to existing studies,thrombolytic therapy,antiplatelet therapy,anti coagulation,defibrintion,neuroprotection and endovascular treatment are all applicable.Therefore,the purpose of this study is to observe the independent risk factors of PIS and to compare the difference between the anterior circulation infarct(ACI)and the posterior circulation infarct(PCI)in the PIS,and provide a rich theoretical basis for the treatment of cerebrovascular diseases in clinical.MethodsThis study is a single center retrospective study.98 patients with PIS,who were diagnosed in the Department of Neurology,the First Affiliated Hospital of Xiamen University,January 1,2015-January 1,2017,were collected and collected for the basic information,previous history,responsible blood vessels,cardiovascular and cerebrovascular risk factors,main auxiliary examination indexes,the time of admission or the peak and NIHSS score before discharge.At the same time,100 patients with acute ischemic stroke(AIS)were collected continuously in the same period of hospitalization.The risk factors of the basic information were analyzed according to the basic information of the SPSS software in the two groups using the same basic treatment.The independent risk factors of PIS were screened out.The levels of fibrinogen(fibrinogen,FIB)of ACI and PCI in the PIS group were compared.According to the NIHSS score and the mRS score,the therapeutic effect of the patients with ACI and PCI infarcts in the hospital and the recovery period were compared respectively.ResultsAccording to the basic data,the history of diabetes in PIS group,the level of FIB in hospital and the total cholesterol(total cholesterol,TC)were significantly higher than those in the NPIS group(P<0.05).Patients with elevated FIB,a history of diabetes and high TC had a higher risk of END than the NPIS group.Moreover,FIB(OR=1.33,95%CI=1.03-1.71),diabetes mellitus(OR=2.53,95%CI=1.23-5.20)and TC(OR=1.36,95%CI=1.04-1.80)were independent risk factors for PIS.In group PIS and group NPIS,all of them were mostly infarcted with ACI.In group PIS,ACI accounted for about 71%,PCI accounted for about 29%,ACI in group NPIS accounted for 60%,PCI accounted for 40%,and two groups showed no significant difference(P=0.09).The levels of FIB in ACI and PCI in group PIS were compared.The FIB level in ACI-PIS was higher than that in PCI-PIS and P<0.05 was statistically different.In the comparison of curative effect,the mRS score of ACI-PIS and PCI-PIS was 0.06 in the prognosis.Although not significant,the P value is small,suggesting that there may be significant differences.ConclusionsDiabetes history,FIB and TC are high risk factors for PIS,among which diabetes history and FIB are independent risk factors for PIS.There was no significant difference in the distribution of ACI and PCI.PIS and NPIS.in PIS,the level of ACI-FIB is higher than that of PCI-FIB,has statistical difference,suggesting that the application of defibrinogen in ACI-PIS may be more effective.the mRS score of ACI-PIS and PCI-PIS was 0.06 in the prognosis,suggesting that ACI-PIS may have a better prognosis. |
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