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Objective To discuss the relationship between serum lipoprotein-associated phospholipase A2(Lp-PLA2),low-density lipoprotein(LDL),amyloid beta 1-42(Aβ1-42)and soluble intercellular adhesion molecule-1(sICAM-1)levels,the National Institutes of Health Stroke Scale(NIHSS)score and prognosis in patients with acute ischemic stroke(AIS).Methods A total of 106 patients with AIS who underwent intravenous thrombolysis(the thrombolysis group),30 AIS patients without thrombolysis(the non-thrombolysis group)and 95 healthy individuals(the control group)were included in the study.The thrombolysis group was divided into the recanalization group(n=41)and the non-recanalization group(n=65)according to whether the vein was recanalized after thrombolysis.Patients were divided into the mild group(n=45),the moderate group(n=36)and the severe group(n=25)based on the NIHSS score.They were divided into the good prognosis group(n=65)and the poor prognosis group(n=41)based on the modified Rankin Scale(mRS)score.Serum levels of four indexes in different groups were compared.Their relationship with the NIHSS score and the prognosis was analyzed.Results The vein recanalization rate in 106 patients with thrombolysis was 38.68%(41/106).Serum Lp-PLA2,LDL,Aβ1-42 and sICAM-1 levels were lower in the recanalization group than those in the non-canalization group(P＜0.05).Serum Lp-PLA2,LDL,Aβ1-42 and sICAM-1 levels increased successively in the control group,the thrombolysis group and the non-thrombolysis group(P＜0.05).The 4 serum indexes increased with the aggravation of disease condition,and were positively correlated with NIHSS score(P＜0.05).High serum levels of Lp-PLA2,LDL,Aβ1-42 and sICAM-1 were risk factors for poor prognosis of patients with thrombolysis(P＜0.05).The area under the curve(AUC)and specificity of the combination of 4 serum indexes for predicting poor prognosis of patients with thrombolysis were higher than those of prediction with single index(P＜0.05).Conclusion The expression levels of serum Lp-PLA2,LDL,Aβ1-42 and sICAM-1 in patients with AIS are high.They can be used as important reference indexes for disease condition monitoring and prognosis evaluation.
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Objective To explore the effect of argatroban injection on serum copeptin, NT-proBNP levels and clinical efficacy in patients with acute cerebral infarction.Methods 120 patients with acute cerebral infarction were selected neural department of internal medicine in our hospital .They were randomly divided into two groups, 60 patients in control group, treated with bed rest, oxygen, nutrition support treatment, giving control of blood pressure, blood glucose, lipid symptomatic disposal according to the disease, anti platelet aggregation, nourishing brain cells and other conventional treatment, 7 days for a course of treatment two course of treatment;the experimental group in the control group based on routine treatment, the first days with argatroban 60 mg,500 mL diluted with normal saline, 60 mg/d, 24 hcontinuous intravenous infusion for second days was given argatroban 20 mg, 200 mL diluted with normal saline,continuous intravenous pumping, total treatment 14 d.After the end of treatment, compared before and after treatment in patients with NIHSS (America National Institutes of Health Stroke), Barthel score (ADL) index score, serum copeptin, NT-proBNP levels and clinical efficacy.Results The two groups after treatment in patients with neurological functions were improved, compared with the control group, patients in the experimental group the NIHSS score was significantly lower , the difference was statistically significant (P<0.05).7 days after treatment, two groups of patients with self-care ability were improved, compared with the control group, patients in the experimental group significantly increased Barthel index score, the difference was statistically significant ( P <0.05 ); 14 days after treatment, compared with control group, patients in the experimental group significantly increased Barthel index score, the difference was statistically significant (P<0.05);14 days after treatment, compared with the same group 7days after treatment, patients in the experimental group significantly increased Barthel index score, the difference was statistically significant (P<0.05).After the treatment two groups of patients with serum copeptin, NT-proBNP levels were decreased, the experimental group patients serum copeptin, NT-proBNP levels were significantly lower than the control group, the difference was statistically significant (P <0.05). Efficiency of total the experiment group (96.7%) was significantly higher than the control group (80%), the difference was statistically significant (P<0.05).Conclusion Argatroban can significantly reduce the levels of serum copeptin, NT-proBNP levels in patients with, improve self-care ability recovery of nerve function and life, has a good clinical effect.
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Non-alcoholic fatty liver disease (NAFLD) is an important type in chronic liver diseases. Its incidence is growing. It is regarded as the liver manifestation of metabolic syndrome, which is closely correlated with the onset of cardiocerehrovascular diseases. The prevention of stroke in patients with NAFLD is very important. Statius are the most important type of medications. They decrease cholesterol synthesis, upregulate low-density lipoprotein (LDL) receptor in the liver and lower the levels of low-density lipoprotein cholesterol (LDL-C) in circulation through inhibiting hydroxy-methyl-glutaryl coenzyme A (HMG-CoA) reductase, and thus effectively reduce the risks of stroke. Besides, the pleiotropy of statins and their effects on cholesterol-related cell signaling pathway may relieve or prevent the progression of NAFLD. There is greater controversy about whether statins can be used in patients with chronic liver diseases because they have some adverse reactions on liver, The evidence available has demonstrated that statins can he used safely in patients with NAFLD, and usually liver enzymes have no need to be monitored. Too much attention on the liver toxicity of statins may result in inappropriate drug withdrawal, and brings about the increased risk of cardiovascular events. So further evaluation is needed for the efficacy and safety of statins in patients with NAFLD.