| ObjectiveThe purpose of this study was to analyze the clinical characteristics of cardiogenic cerebral infarction and to observe the predictive acute of early troponin I elevation and STAF score in the diagnosis of cardiogenic cerebral infarction.MethodsThis research collected consecutive acute ischaemic stroke patients during the 2016-10 to 2018-01 in the first affiliated hospital of Xiamen university neurology hospital into the standard of diagnosis and treatment.Admission criteria and exclusion criteria should be met.Collect into a group of patients at the same time detailed clinical data,including demographic data,national institudes of health stroke scale NIHSS score,during 24 hours dynamic electrocardiogram,echocardiography,imaging index,at the same time,using chemiluminescence immunoassay detection in patients with serum cardiac troponin(cTnl)concentrations,on the basic data and auxillary examination results calculated in hospital patients STAF score.According to the TOAST classification,the patients were divided into cardiogenic cerebral infarction group and non-cardiac cerebral infarction group.The clinical baseline data of the two groups were compared,and analyzed the clinical characteristics of the cardiogenic cerebral infarction group.A ROC curve was used to determine the boundary value of cTnI and STAF scores in diagnosing cardiogenic cerebral infarction and to compare and analyze its predictive value.Results1、275 patients were included in the research.38 patients were divided into cardiogenic cerebral infarction group and 185 were divided into non-cardiac cerebral infarction group(except for unknown reasons).Compared the two groups of clinical baseline,the NCCI group of patients with hypertension,diabetes,smoking history,are more than in the CCI group(P<0.05).On the other hand,in the CCI group the patients are older,with atrial fibrillation,ischemic heart disease are more,and NIHSS score,the value of cTnI and STAF score are significantly higher than in the NCCI group(P<0.05).2、38 patients with cardiac cerebral infarction were large area cerebral infarction,most of which were involved in cerebral cortex(30 cases)and basal ganglia(19 cases),and the internal carotid artery system(22 cases).All the 38 patients with cardiac cerebral infarction were detected by echocardiography and electrocardiogram,with the highest number of atrial fibrillation(28 cases)and enlargement of the left atrium(20 cases).3、The area under the ROC curve of STAF score in the CCI group is(0.954),the its 95%confidence interval(0.924,0.985).The area under the ROC curve of the cTnI value in the CCI group is(0.852),the its 95%confidence interval(0.788,0.916).The cutoff of STAF score is 4 points,with a sensitivity of 92.1%and a specificity of 89.2%.The cutoff of cTnI value is 0.0085ng/ml,with a sensitivity of 73.7%and a specificity of 84.9%.Conclusion1、The clinical symptoms of cardiogenic cerebral infarction are heavy,and the infarction is extensive,and the cortex and basal ganglia are the most afected,and the internal carotid system are the most involved.The most common risk of cardiogenic cerebral infarction are atrial fibrillation and enlarged left atrium.2、Serum cTnI value and STAF score have good predictive value for car diogenic cerebral infarction,and STAF score has more higher value than serum cTnI in predicting the diagnosis of cardiac cerebral infarction.Therefore,serum cTnI can be used for emergency department of hospitalized patients with acute ischaemic stroke etiology classification of early screening.STAF score can be used to guide the secondary prevention in patients with acute ischaemic stroke. |
