目的:分析血清中Caspase酶切割细胞角蛋白18的裂解产物CCCK-18与单纯硬膜外血肿并脑疝患者术后继发性脑梗死发生发展的关系,评价CCCK-18对继发性脑梗死的早期预测能力及临床决策价值。方法:回顾性分析206例单纯硬膜外血肿并脑疝患者术...目的:分析血清中Caspase酶切割细胞角蛋白18的裂解产物CCCK-18与单纯硬膜外血肿并脑疝患者术后继发性脑梗死发生发展的关系,评价CCCK-18对继发性脑梗死的早期预测能力及临床决策价值。方法:回顾性分析206例单纯硬膜外血肿并脑疝患者术前血清CCCK-18浓度与术后继发性脑梗死占位体积的潜在关系。结果:术后继发脑梗死49例(23.78%),其中占位体积>20 mL 32例(15.53%)纳入大面积脑梗死组;占位体积<20 mL 17例(8.25%)纳入小面积脑梗死组,无脑梗死157例(76.21%)纳入无脑梗死组。大面积脑梗死组患者术前CCCK-18浓度显著高于小面积脑梗死组和无脑梗死组(均P<0.001)。术前血清CCCK-18水平与继发性脑梗死的占位体积呈线性相关(P<0.001)。受试者工作曲线分析提示术前血清CCCK-18水平对术后继发性大面积脑梗死的曲线下面积为0.814(P<0.001),以241 U/L为预测界值的准确度达到83.50%。多因素logistic回归分析表明,CCCK-18>241 U/L是单纯硬膜外血肿并脑疝患者术后继发大面积脑梗死的独立危险因素(P<0.001)。术后随访6个月,术前血清CCCK-18>241 U/L患者的格拉斯哥预后量表(GOS)评分明显低于CCCK-18<241 U/L的患者(P<0.001)。结论:术前血清CCCK-18增高与单纯硬膜外血肿致脑疝患者术后继发性大面积脑梗死密切相关,可作为辅助决策此类患者去骨瓣减压手术模式并预估长期神经功能预后的生物标志物。展开更多
BACKGROUND： Stroke prevention guidelines should be made available application to aid in uniformity, timing, preciseness, and acceptance of disease. OBJECTIVE： To investigate the awareness of neurologists in some Bei...BACKGROUND： Stroke prevention guidelines should be made available application to aid in uniformity, timing, preciseness, and acceptance of disease. OBJECTIVE： To investigate the awareness of neurologists in some Beijing secondary prevention of cerebral infarction/transient ischemia. DESIGN： Cross-sectional study. to neurologists for clinical hospitals of intervention in SETTING： Beijing Tiantan Hospital, Beijing Anzhen Hospital, General Hospital of Beijing Military Area, Command of Chinese PLA, Beijing Chuiyangliu Hospital, Beijing 6^th Hospital, Beijing Hepingli Hospital, and Beijing Daxing District Hospital. PARTICIPANTS： A total of 28 （associate） chief physicians, 58 attending physicians, and 54 resident physicians who engaged in clinical treatment of cerebrovascular diseases were selected from 8 hospitals in Beijing from March to April 2007. All physicians provided informed consent. METHODS： Self-made closed questionnaires were provided for data collection, consisting of 16 questions that were single choice or multiple choice. Specifically, questions 1-7 focused on awareness of blood pressure regulation in different patients and first choice of decompression drug; questions 8-12 focused on awareness of lipid regulation; and questions 13-16 focused on awareness of anti-blood platelet drugs applied in secondary prevention. The scores ranged from 0-100 points, and each question was worth 6.25 points. The scores positively correlated with the awareness rate. To test leveling real-time, the survey lasted for a maximum of 20 minutes. One questionnaire was independently finished by each subject in the survey. MAIN OUTCOME MEASURES： Awareness intervention among neurologists during secondary prevention of cerebral infarction/transient ischemia and questionnaire scores. RESULTS： 140 subjects were included in the final analysis. ① The awareness rate among neurologists for intervention during secondary prevention of cerebral infarction/transient ischemia ranged from 0.7-57.9%, the scores ranged betw展开更多
文摘目的:分析血清中Caspase酶切割细胞角蛋白18的裂解产物CCCK-18与单纯硬膜外血肿并脑疝患者术后继发性脑梗死发生发展的关系,评价CCCK-18对继发性脑梗死的早期预测能力及临床决策价值。方法:回顾性分析206例单纯硬膜外血肿并脑疝患者术前血清CCCK-18浓度与术后继发性脑梗死占位体积的潜在关系。结果:术后继发脑梗死49例(23.78%),其中占位体积>20 mL 32例(15.53%)纳入大面积脑梗死组;占位体积<20 mL 17例(8.25%)纳入小面积脑梗死组,无脑梗死157例(76.21%)纳入无脑梗死组。大面积脑梗死组患者术前CCCK-18浓度显著高于小面积脑梗死组和无脑梗死组(均P<0.001)。术前血清CCCK-18水平与继发性脑梗死的占位体积呈线性相关(P<0.001)。受试者工作曲线分析提示术前血清CCCK-18水平对术后继发性大面积脑梗死的曲线下面积为0.814(P<0.001),以241 U/L为预测界值的准确度达到83.50%。多因素logistic回归分析表明,CCCK-18>241 U/L是单纯硬膜外血肿并脑疝患者术后继发大面积脑梗死的独立危险因素(P<0.001)。术后随访6个月,术前血清CCCK-18>241 U/L患者的格拉斯哥预后量表(GOS)评分明显低于CCCK-18<241 U/L的患者(P<0.001)。结论:术前血清CCCK-18增高与单纯硬膜外血肿致脑疝患者术后继发性大面积脑梗死密切相关,可作为辅助决策此类患者去骨瓣减压手术模式并预估长期神经功能预后的生物标志物。
基金Key Research Task of Science and Technology Department of Beijing, No.D0905004000011
文摘BACKGROUND： Stroke prevention guidelines should be made available application to aid in uniformity, timing, preciseness, and acceptance of disease. OBJECTIVE： To investigate the awareness of neurologists in some Beijing secondary prevention of cerebral infarction/transient ischemia. DESIGN： Cross-sectional study. to neurologists for clinical hospitals of intervention in SETTING： Beijing Tiantan Hospital, Beijing Anzhen Hospital, General Hospital of Beijing Military Area, Command of Chinese PLA, Beijing Chuiyangliu Hospital, Beijing 6^th Hospital, Beijing Hepingli Hospital, and Beijing Daxing District Hospital. PARTICIPANTS： A total of 28 （associate） chief physicians, 58 attending physicians, and 54 resident physicians who engaged in clinical treatment of cerebrovascular diseases were selected from 8 hospitals in Beijing from March to April 2007. All physicians provided informed consent. METHODS： Self-made closed questionnaires were provided for data collection, consisting of 16 questions that were single choice or multiple choice. Specifically, questions 1-7 focused on awareness of blood pressure regulation in different patients and first choice of decompression drug; questions 8-12 focused on awareness of lipid regulation; and questions 13-16 focused on awareness of anti-blood platelet drugs applied in secondary prevention. The scores ranged from 0-100 points, and each question was worth 6.25 points. The scores positively correlated with the awareness rate. To test leveling real-time, the survey lasted for a maximum of 20 minutes. One questionnaire was independently finished by each subject in the survey. MAIN OUTCOME MEASURES： Awareness intervention among neurologists during secondary prevention of cerebral infarction/transient ischemia and questionnaire scores. RESULTS： 140 subjects were included in the final analysis. ① The awareness rate among neurologists for intervention during secondary prevention of cerebral infarction/transient ischemia ranged from 0.7-57.9%, the scores ranged betw
