Objective To investigate the outcome and prognostic factors of hospital mortality in patients with acute cerebrovascular disease requiring mechanical ventilation.Methods Data from 94 patients with acute cerebrovascular disease in central intensive care unit(ICU) were collected and retrospectively analyzed.Prognostic factors of hospital mortality were analyzed by univariate statistics and multivariate logistic regression.Results Hospital mortality was 53.2%(50/94).There was significance diference in parameters such as APACHE II score，blood glucose，lengh of hospital stay，lengh of ICU stay，time of mechanical ventilation，incision of trachea，lung infections，lesion loci and its naturer between the survival and non-survival groups（all Plt;0.05）.Multivariate logistic regression revealed that blood glucose，lung infections，diseased region under tentorium of cerebellum，time of mechanical ventilation were independent prognostic risk factors of hospital mortality(all Plt;0.05).Whereas the lengh of ICU stay was protective factor(Plt;0.05).Conclusion The hospital mortality is considerably high in patients with acute cerebrovascular disease requiring mechanical ventilation. The prognostic factors such as blood glucose and lung infections should be evaluate cautiously and prevented aggressively.
目的 探讨缺血性脑血管病患者高同型半胱氨酸(Hcy)血症与颅内外动脉狭窄的关系。 方法 2007年6月-2009年12月收治缺血性脑血管病患者90例，根据全脑血管造影检查结果分为颅内外动脉狭窄组和颅内外动脉无狭窄组；颅内外动脉狭窄组依狭窄部位分为单纯颅内动脉狭窄组、单纯颅外动脉狭窄组及颅内外动脉均有狭窄组；分析各组同型半胱氨酸的水平。 结果 颅内外动脉狭窄组血浆Hcy水平显著高于颅内外动脉无狭窄组(Plt;0.05)；单纯颅内动脉狭窄组、单纯颅外动脉狭窄组及颅内外动脉均有狭窄组血浆Hcy水平均显著高于颅内外动脉无狭窄组(Plt;0.05)。 结论 高同型半胱氨酸血症是颅内外动脉狭窄的危险因素，是单纯颅内动脉狭窄及单纯颅外动脉狭窄的共同危险因素。
目的:探讨普罗布考对动脉粥样硬化性脑梗死并高脂血症患者血脂及预后的影响。方法:将87例脑梗死并高脂血症患者随机分为两组,治疗组44例,对照组43例,两组除按动脉粥样硬化性脑梗死常规治疗外,停用一切降脂药物。治疗组给予普罗布考500mg bid/d。疗程为6个月。随访一年观察两组患者治疗后血脂水平及脑血管事件发生情况。结果:治疗组患者治疗前、后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)间差异均有显著性意义(Plt;0.05)。两组患者治疗后各项血脂指标间差异均有显著性意义(Plt;0.05)。随访一年,显示治疗组患者心脑血管事件14次,对照组19次(Plt;0.05)。结论:普罗布考降脂疗效可靠、副作用轻微,降低心脑血管事件发生。可作为动脉粥样硬化性脑梗死并高脂血症患者的一、二级预防药物。
ObjectiveTo analysis the risk factors for carotid stenosis in patients with ischemic cerebrovascular disease based on digital subtraction angiography. MethodsA total of 312 patients diagnosed with ischemic cerebrovascular disease who underwent digital subtraction angiography from June 2011 to September 2013 were selected.The risk factors of carotid stenosis were analysised by multivariate logistic regression analysis. ResultsIn 312 patients,271 were with cerebral infarction and 41 were transient ischemic attack patients.There were 149 patients in carotid stenosis group (stenosis degree ≥50%) and 163 patients in control group (stenosis degree<50%).The age (OR=1.037,P=0.000) and coronary heart disease (OR=4.121,P=0.001) were independent risk factors of carotid stenosis with ischemic cerebrovascular disease. ConclusionCarotid stenosis is common in ischemic cerebrovascular disease.Age and coronary heart disease were the independent risk factors.The recognition and control of these risk factors are in favor of secondary prevention of ischemic cerebrovascular disease.
Abstract Precision medicine is an ideal medical paradigm which combines modern scientific methods with traditional medical methods to diagnose, treat and evaluate the physical function and nature of diseases more precisely, and to maximize health benefits and minimize the risk of individuals and society with the most effective, safest, and the most economical medical service. Evidence-based medicine is necessary to verify the precision of diagnosis and treatment. In this review, we clarified the conception of precision medicine and the relation between precision medicine and evidence-based medicine. Moreover, we reviewed the application of precision medicine in the field of cerebrovascular disease. We pointed out that such new technologies as genetics, bioinformatics, molecular imaging and management provided tools to realize the idea of precision medicine, and high-quality evidence-based studies provided a guarantee for the clinical practice of precision medicine. In summary, precision medicine is an individualized medical mode that based on the context of a patient's genetic information, living environment and clinical data, etc. to provide precise treatment strategies for the prevention and treatment of disease, but still the promotion of precision medicine should be based on clinical validation under the guidance of evidence-based medicine. Thus, long-term exploration and unremitting efforts are required to achieve the idea of precision medicine.