BACKGROUND Acute cerebral infarction is a severe type of ischemic stroke that can be divided into anterior circulation cerebral infarction and posterior circulation cerebral infarction(PCCI).PCCI affects the structure...BACKGROUND Acute cerebral infarction is a severe type of ischemic stroke that can be divided into anterior circulation cerebral infarction and posterior circulation cerebral infarction(PCCI).PCCI affects the structure of the posterior circulation brain,because posterior part of the brain,which has more complex anatomical structures and more prone to posterior circulation vascular variation.Therefore,improving the prognosis of PCCI patients is necessary.AIM To explore the effect of medical care linkage-continuous management mode(MCLMM)on endovascular interventional therapy(EIT)for PCCI.METHODS Sixty-nine patients with PCCI who received EIT and conventional nursing intervention were selected as the control group,and 78 patients with PCCI who received EIT and MCLMM intervention were selected as the observation group.The incidence of postoperative complications,compliance and disease selfmanagement behavior after six months of intervention,modified Rankin scale(mRS)and Barthel index(BI)scores in the acute phase and after one year of intervention,and recurrence within one year were compared between the two groups.RESULTS The total incidence rate of postoperative complications in the observation group(7.69%)was lower than that in the control group(18.84%)(P<0.05).The scores for medical compliance behavior(regular medication,appropriate diet,and rehabilitation cooperation rates)and disease self-management behavior(self-will,disease knowledge,and self-care ability)in the observation group were higher than those in the control group(P<0.05).After one year of intervention,in the observation group,the mRS score was significantly lower,and the BI score was significantly higher than those in the control group(P<0.05).The recurrence rate within one year in the observation group(3.85%)was significantly lower than that in the control group(13.04%)(P<0.05).CONCLUSION MCLMM can reduce the incidence of complications after EIT for PCCI,improve patient compliance behavior and disease self-management ability,and promote the recovery of neurological function.展开更多
Objective:To study the correlation of serum platelet activating factor (PAF) level with inflammatory response indexes and blood lipid metabolism in patients with posterior circulation cerebral infarction.Methods: Pati...Objective:To study the correlation of serum platelet activating factor (PAF) level with inflammatory response indexes and blood lipid metabolism in patients with posterior circulation cerebral infarction.Methods: Patients who were hospitalized and diagnosed with posterior circulation cerebral infarction in Neurology Department of Foshan Second People's Hospital between October 2016 and October 2017 were selected as the cerebral infarction group of the research, and healthy volunteers who received physical examination in the hospital during the same period were selected as control group. Serum was collected to determine the contents of PAF, inflammatory response indexes and lipid metabolism indexes.Results:Serum PAF, HMGB1, FKN, CD40L, IL-18, HCY, DKK1, LDL-C, Vaspin and Resistin levels of cerebral infarction group were greatly higher than those of control group whereas Visfatin level was greatly lower than that of control group;serum HMGB1, FKN, CD40L, IL-18, HCY, DKK1, LDL-C, Vaspin and Resistin levels of cerebral infarction group of patients with high PAF level were greatly higher than those of patients with low PAF level whereas Visfatin level was greatly lower than that of patients with low PAF level.Conclusion: The increase of PAF content in serum of patients with posterior circulation cerebral infarction is closely related to the inflammatory response activation and lipid metabolism disorder.展开更多
Objective: To study the evaluation value of CTA for vertebrobasilar artery stenosis in patients with posterior circulation cerebral infarction and its correlation with serum biochemical indexes. Methods: A total of 14...Objective: To study the evaluation value of CTA for vertebrobasilar artery stenosis in patients with posterior circulation cerebral infarction and its correlation with serum biochemical indexes. Methods: A total of 148 patients who were treated in Maanshan Shiqiye Hospital between June 2014 and February 2017 due to vertebrobasilar artery stenosis were selected as the research subjects and divided into cerebral infarction group and transient ischemic attack (TIA) group according to the imageological examination. CTA was used to evaluate vertebrobasilar atherosclerotic plaque properties, and enzyme-linked immunosorbent assay kit was used to determine the levels of nerve injury markers, inflammatory response-related molecules and plaque property-related protease molecules. Results: The positive rate of posterior circulation plaque in cerebral infarction group was obviously higher than that in TIA group, and the positive rate of unstable plaque, fibrous plaque and calcified plaque were higher than those in TIA group;serum NSE, S100B, UCH-L1, GFAP, ICAM-1, VCAM-1, PECAM-1, VE-cadherin, YKL-40, CatS, MMP9, MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque, fibrous plaque and calcified plaque were all higher than those of TIA group;serum NSE, S100B, UCH-L1, GFAP, ICAM-1, VCAM-1, PECAM-1, VE-cadherin, YKL-40, CatS, MMP9, MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque and fibrous plaque were all higher than those of patients with calcified plaque, and serum NSE, S100B, UCH-L1, GFAP, ICAM-1, VCAM-1, PECAM-1, VE-cadherin, YKL-40, CatS, MMP9, MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque were all higher than those of patients with fibrous plaque. Conclusion: CTA can accurately assess the property of vertebrobasilar atherosclerotic plaque in patients with posterior circulation cerebral infarction and is closely related to the degree of nerve injury and the change of plaque property.展开更多
Objective:To understand the clinical characteristics of patients with embryonic posterior cerebral artery and its correlation with abnormal vascular development.Methods:The clinical data of 396 patients with embryonic...Objective:To understand the clinical characteristics of patients with embryonic posterior cerebral artery and its correlation with abnormal vascular development.Methods:The clinical data of 396 patients with embryonic posterior cerebral artery confirmed by magnetic resonance angiography(MRA)and computed tomography angiography(CTA)were analyzed.Results:Two-hundred patients had clinical manifestations of posterior circulation ischemia,including recurrent dizziness,vertigo,and tinnitus;45 had headaches,97 had limb weakness,and 16 patients had syncope or impaired consciousness.Seventy-six patients with circulatory infarction were admitted to the hospital.There were 251 patients with history of hypertension,74 with diabetes,113 with hyperlipidemia,13 with dominant vertebral artery,10 with intracranial aneurysm,and 19 with absence of A1 segment of the anterior cerebral artery(considering developmental variation).Conclusion:Embryonic posterior cerebral artery develops abnormally during the embryonic period,often accompanied by abnormal vascular access.Due to abnormal hemodynamics,the incidence of posterior circulation ischemia,aneurysm,and infarction increases in such patients.展开更多
目的探讨冠状动脉(冠脉)侧支循环在老年急性前壁心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术中的心肌保护作用及对预后的影响。方法连续入选2016年1月至2019年12月于朝阳市中心医院心血管内科收治接受急诊PCI的老年(>60岁)急性前...目的探讨冠状动脉(冠脉)侧支循环在老年急性前壁心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术中的心肌保护作用及对预后的影响。方法连续入选2016年1月至2019年12月于朝阳市中心医院心血管内科收治接受急诊PCI的老年(>60岁)急性前壁心肌梗死患者206例为研究对象,分为侧支循环发育良好组(n=82)和发育不良组(n=124)。比较两组患者基线资料、手术相关指标与预后情况。结果侧支循环发育良好组患者心绞痛病程[(18.4±9.2 vs. 10.4±7.9)月,P<0.001]显著长于侧支循环发育不良组,肌酸激酶同工酶(CK-MB)峰值[(86.4±23.1 vs. 112.8±42.4)ng/ml,P=0.021]和肌钙蛋白I(cTnI)峰值[(6624.2±1893.4 vs. 8724.2±2314.1)pg/ml,P=0.034]显著低于侧支发育不良组。与侧支发育不良组比较,侧支循环发育良好组PCI相关心肌梗死发生率(14.6%vs. 30.6,P=0.012)和慢血流/无复流发生率更低(13.4%vs. 26.6%,P=0.025),术后校正的TIMI帧数[(20.1±10.0 vs. 24.7±14.6)帧,P=0.033]显著低于侧支发育不良组。随访1月,侧支发育良好组左室射血分数(LVEF)(43.7±8.1 vs. 40.4±6.4,P=0.012)显著高于侧支发育不良组,左室舒张末容积(LVEDV)[(114.4±22.3 vs.125.2±32.1)ml,P=0.033]和左室收缩末容积(LVESV)[(64.4±16.4 vs. 74.6±20.1)ml,P=0.014]显著低于侧支发育不良组;侧支发育良好组心力衰竭发生率(13.2%vs. 24.2%,P=0.047)和总主要不良心脑血管事件(MACCE)(28.6%vs. 42.7%,P=0.026)显著低于侧支循环发育不良组。结论老年急性前壁心肌梗死侧支循环发育良好可改善心肌微灌注,抑制心室重构,改善患者心功能。展开更多
文摘BACKGROUND Acute cerebral infarction is a severe type of ischemic stroke that can be divided into anterior circulation cerebral infarction and posterior circulation cerebral infarction(PCCI).PCCI affects the structure of the posterior circulation brain,because posterior part of the brain,which has more complex anatomical structures and more prone to posterior circulation vascular variation.Therefore,improving the prognosis of PCCI patients is necessary.AIM To explore the effect of medical care linkage-continuous management mode(MCLMM)on endovascular interventional therapy(EIT)for PCCI.METHODS Sixty-nine patients with PCCI who received EIT and conventional nursing intervention were selected as the control group,and 78 patients with PCCI who received EIT and MCLMM intervention were selected as the observation group.The incidence of postoperative complications,compliance and disease selfmanagement behavior after six months of intervention,modified Rankin scale(mRS)and Barthel index(BI)scores in the acute phase and after one year of intervention,and recurrence within one year were compared between the two groups.RESULTS The total incidence rate of postoperative complications in the observation group(7.69%)was lower than that in the control group(18.84%)(P<0.05).The scores for medical compliance behavior(regular medication,appropriate diet,and rehabilitation cooperation rates)and disease self-management behavior(self-will,disease knowledge,and self-care ability)in the observation group were higher than those in the control group(P<0.05).After one year of intervention,in the observation group,the mRS score was significantly lower,and the BI score was significantly higher than those in the control group(P<0.05).The recurrence rate within one year in the observation group(3.85%)was significantly lower than that in the control group(13.04%)(P<0.05).CONCLUSION MCLMM can reduce the incidence of complications after EIT for PCCI,improve patient compliance behavior and disease self-management ability,and promote the recovery of neurological function.
文摘Objective:To study the correlation of serum platelet activating factor (PAF) level with inflammatory response indexes and blood lipid metabolism in patients with posterior circulation cerebral infarction.Methods: Patients who were hospitalized and diagnosed with posterior circulation cerebral infarction in Neurology Department of Foshan Second People's Hospital between October 2016 and October 2017 were selected as the cerebral infarction group of the research, and healthy volunteers who received physical examination in the hospital during the same period were selected as control group. Serum was collected to determine the contents of PAF, inflammatory response indexes and lipid metabolism indexes.Results:Serum PAF, HMGB1, FKN, CD40L, IL-18, HCY, DKK1, LDL-C, Vaspin and Resistin levels of cerebral infarction group were greatly higher than those of control group whereas Visfatin level was greatly lower than that of control group;serum HMGB1, FKN, CD40L, IL-18, HCY, DKK1, LDL-C, Vaspin and Resistin levels of cerebral infarction group of patients with high PAF level were greatly higher than those of patients with low PAF level whereas Visfatin level was greatly lower than that of patients with low PAF level.Conclusion: The increase of PAF content in serum of patients with posterior circulation cerebral infarction is closely related to the inflammatory response activation and lipid metabolism disorder.
基金Natural Science Foundation of Anhui Province No:1308085MH158.
文摘Objective: To study the evaluation value of CTA for vertebrobasilar artery stenosis in patients with posterior circulation cerebral infarction and its correlation with serum biochemical indexes. Methods: A total of 148 patients who were treated in Maanshan Shiqiye Hospital between June 2014 and February 2017 due to vertebrobasilar artery stenosis were selected as the research subjects and divided into cerebral infarction group and transient ischemic attack (TIA) group according to the imageological examination. CTA was used to evaluate vertebrobasilar atherosclerotic plaque properties, and enzyme-linked immunosorbent assay kit was used to determine the levels of nerve injury markers, inflammatory response-related molecules and plaque property-related protease molecules. Results: The positive rate of posterior circulation plaque in cerebral infarction group was obviously higher than that in TIA group, and the positive rate of unstable plaque, fibrous plaque and calcified plaque were higher than those in TIA group;serum NSE, S100B, UCH-L1, GFAP, ICAM-1, VCAM-1, PECAM-1, VE-cadherin, YKL-40, CatS, MMP9, MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque, fibrous plaque and calcified plaque were all higher than those of TIA group;serum NSE, S100B, UCH-L1, GFAP, ICAM-1, VCAM-1, PECAM-1, VE-cadherin, YKL-40, CatS, MMP9, MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque and fibrous plaque were all higher than those of patients with calcified plaque, and serum NSE, S100B, UCH-L1, GFAP, ICAM-1, VCAM-1, PECAM-1, VE-cadherin, YKL-40, CatS, MMP9, MMP10 and ADAMTS12 levels of cerebral infarction group of patients with unstable plaque were all higher than those of patients with fibrous plaque. Conclusion: CTA can accurately assess the property of vertebrobasilar atherosclerotic plaque in patients with posterior circulation cerebral infarction and is closely related to the degree of nerve injury and the change of plaque property.
文摘Objective:To understand the clinical characteristics of patients with embryonic posterior cerebral artery and its correlation with abnormal vascular development.Methods:The clinical data of 396 patients with embryonic posterior cerebral artery confirmed by magnetic resonance angiography(MRA)and computed tomography angiography(CTA)were analyzed.Results:Two-hundred patients had clinical manifestations of posterior circulation ischemia,including recurrent dizziness,vertigo,and tinnitus;45 had headaches,97 had limb weakness,and 16 patients had syncope or impaired consciousness.Seventy-six patients with circulatory infarction were admitted to the hospital.There were 251 patients with history of hypertension,74 with diabetes,113 with hyperlipidemia,13 with dominant vertebral artery,10 with intracranial aneurysm,and 19 with absence of A1 segment of the anterior cerebral artery(considering developmental variation).Conclusion:Embryonic posterior cerebral artery develops abnormally during the embryonic period,often accompanied by abnormal vascular access.Due to abnormal hemodynamics,the incidence of posterior circulation ischemia,aneurysm,and infarction increases in such patients.
文摘目的探讨冠状动脉(冠脉)侧支循环在老年急性前壁心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术中的心肌保护作用及对预后的影响。方法连续入选2016年1月至2019年12月于朝阳市中心医院心血管内科收治接受急诊PCI的老年(>60岁)急性前壁心肌梗死患者206例为研究对象,分为侧支循环发育良好组(n=82)和发育不良组(n=124)。比较两组患者基线资料、手术相关指标与预后情况。结果侧支循环发育良好组患者心绞痛病程[(18.4±9.2 vs. 10.4±7.9)月,P<0.001]显著长于侧支循环发育不良组,肌酸激酶同工酶(CK-MB)峰值[(86.4±23.1 vs. 112.8±42.4)ng/ml,P=0.021]和肌钙蛋白I(cTnI)峰值[(6624.2±1893.4 vs. 8724.2±2314.1)pg/ml,P=0.034]显著低于侧支发育不良组。与侧支发育不良组比较,侧支循环发育良好组PCI相关心肌梗死发生率(14.6%vs. 30.6,P=0.012)和慢血流/无复流发生率更低(13.4%vs. 26.6%,P=0.025),术后校正的TIMI帧数[(20.1±10.0 vs. 24.7±14.6)帧,P=0.033]显著低于侧支发育不良组。随访1月,侧支发育良好组左室射血分数(LVEF)(43.7±8.1 vs. 40.4±6.4,P=0.012)显著高于侧支发育不良组,左室舒张末容积(LVEDV)[(114.4±22.3 vs.125.2±32.1)ml,P=0.033]和左室收缩末容积(LVESV)[(64.4±16.4 vs. 74.6±20.1)ml,P=0.014]显著低于侧支发育不良组;侧支发育良好组心力衰竭发生率(13.2%vs. 24.2%,P=0.047)和总主要不良心脑血管事件(MACCE)(28.6%vs. 42.7%,P=0.026)显著低于侧支循环发育不良组。结论老年急性前壁心肌梗死侧支循环发育良好可改善心肌微灌注,抑制心室重构,改善患者心功能。
