| Objective:To explore early warning indicators of END(Early Neurological Deterioration)from genetic polymorphism and serum lipid profiles perspectives in patients with acute ischemic stroke(IS).Methods:414 patients with acute first-episode IS were recruited in neurology department of our hospital from June 2017 to December 2018.Patients were divided into the control group without END and the case group with END.END was defined as any new neurological symptoms or any apparent neurological worsening occurring within 1 week after IS onset.Clinical data and laboratory findings from all participants were collected.All the data were analyzed by Chi square test,t test,Logistic regression analysis and Partial-Cross-Correlation Analysis.Result:First,26.57% of the first-episode IS patients experienced END during the acute phase.Moreover,most END occurred mainly within 3 days after IS onsetSecond,NIHSS score at admission was an independent predictor of END(p <0.05).Third,total cholesterol was associated with disease severity at admission(B =3.60,t = 13.72,p < 0.001).Fourth,total cholesterol levels were associated with END in acute IS patients(p < 0.001).Compared with the lowest quartile,the third(adjusted OR = 3.98,95%CI 1.17-13.58,p = 0.0274)and the fourth(adjusted OR=5.07,95%CI1.41-18.28,p = 0.0131)quartiles of cholesterol were independently associated with END.Fifth,APOE polymorphism were associated with END(p = 0.0021).After adjustment for covariates,there were significant differences in APOE ε4 carrier genotype frequencies in two groups(p = 0.0016,OR:3.32,95%CI: 1.58–6.99).Conclusion:Total cholesterol was independent risk factor for END and may be relative to the severity of IS.APOE ε4 carriers were a valuable independent risk factor for END,which reveals APOE polymorphism may be an independent predictor of END.For first-episode IS patients with ε4 carriers or higher cholesterol level,it may be favorable to take a more active treatment in the acute stage. |
PDF Full Text Request