Background Stroke unit is the most effective treatment method to benefit stroke patients. Our study is to evaluate the early effectiveness of a hospital stroke unit (SU). Methods Three hundred and ninety-two patients ...Background Stroke unit is the most effective treatment method to benefit stroke patients. Our study is to evaluate the early effectiveness of a hospital stroke unit (SU). Methods Three hundred and ninety-two patients who had suffered from acute strokes and who were admitted to our hospital between December 2001 and January 2003 were recruited for this controlled study. All patients were sent at random to either the SU or the general ward (GW) for treatment. The following indices were measured by: Barthel Index (BI),National Institute of Health Stroke Scale (NIHSS),Oxford Handicap Scale (OHS). Results The mean change in BI score between the day of admission and the day of discharge was 20.00±24.36 for the SU group and 10.63±23.59 for the GW group. A difference that is statistically significant ( P =0.000). The mean change in NIHSS score was -2.01±6.61 for the SU group and 0.55±7.44 for the GW group. A difference that is also statistically significant ( P =0.000). Finally,the mean change in OHS score was -0.74±1.04 for the SU group and -0.28±0.98 for the GW group,also a statistically significant difference ( P =0.000). Among SU patients,patient satisfaction was higher ( P =0.000),the rehabilitation success rate was higher ( P =0.000),and there were fewer complications ( P =0.000).Conclusion Compared to GW patients,stroke patients treated in a special SU were able to return to normal daily activities earlier,with better social abilities,and have reduced neurological defects,without increasing the overall economic burden.展开更多
The evidence-based medicine proved that Stroke Unit （SU） works most effectively on stroke. Since SU is originated and developed in Europe and America, SU therapies are limited to Western medicine. We can make flexib...The evidence-based medicine proved that Stroke Unit （SU） works most effectively on stroke. Since SU is originated and developed in Europe and America, SU therapies are limited to Western medicine. We can make flexible clinical guidelines by combining TCM with the SU and establish SU mode with Chinese characteristics.展开更多
BACKGROUND： Acute stroke unit （stroke care unit） is developing in some domestic large-sized hospitals, but most stroke patients need stroke rehabilitation unit therapy, so setting stroke rehabilitation unit in medi...BACKGROUND： Acute stroke unit （stroke care unit） is developing in some domestic large-sized hospitals, but most stroke patients need stroke rehabilitation unit therapy, so setting stroke rehabilitation unit in medium-sized comprehensive community hospital （secondary hospital）, where medical facility is relatively insufficient, is a new pathway to satisfy stroke patients. OBJECTIVE： To observe the comprehensive effect of developing stroke rehabilitation unit based on the facility of secondary hospital and its feasibility. DESIGN： Non-randomized concurrent controlled observation SETTING： Department of Neurology, Beijing Longfu Hospital PARTICIPANTS： Totally 264 stroke reconvalescents who suffered stroke for 7 days and received treatment in the Department of Neurology, Beijing Longfu Hospital during June 2003 to June 2005 were involved in the study. All the involved patients were confirmed by CT or MRI. The patients were scored by using Modified Edinbergh-Scandinavia stroke scale （SSS） 〉 16 points. Written informed consents were obtained from all the patients. The patients were assigned into 2 groups according to the willing of patients and their relatives： （1）treatment group, in which, there were 134 patients, 76 males and 58 females, aged 43 to 74 years; cerebral infarction was found in 116 cases and cerebral hemorrhage in 18 cases;（2） control group, in which, there were 130 patients, 66 males and 64 females, aged 45 to 77 years, cerebral infarction was found in 115 cases and cerebral hemorrhage in 15 cases. There were significant differences in baseline data of the patients between two groups. METHODS： A same basic treatment was conducted in the patients of the two groups. （1） Patients in the treatment group admitted to stroke rehabilitation unit and received comprehensive rehabilitation treatment. The rehabilitation flow-sheet： randomization-letting the patients of treatment group go into the unit-making comprehensive assessment in the initial stage-making therapy plan-talking with patients and their other family members-general rehabilitation-making metaphase assessment-adjusting therapy plan-making final assessment-letting the patients discharge and doing follow-up visits. （2） The patients in the control group admitted to common wards, and they were encouraged to do activities by themselves in the early stage, but did not receive rehabilitation training under the instructions from professional physicians. MAIN OUTCOME MEASURES： The following assessments were conducted on admission and 7 and 28 days after admission： （1） Severity of stroke and motor function： scored as 0 to 45 points by SSS, the higher points, the severer damage. （2）Activities of daily living： Evaluated by Barthel index, 110 points in total, 110 points meant normal, 0 point meant extremely poor. （3）Mental status： evaluated by Hopkin＇s symptom scale with a 5-point scoring. The symptom was scored with low to high points. （4）Cognitive function： Quantification measurement was conducted with LOTCA method. The higher points, the better therapeutic effects. RESULTS： （1） Three cases dropped out and one died in the treatment group, 11 cases dropped out and 4 died in the control group. （2）The neurologic impairment points on 7 and 28 days after therapy in the treatment group were lower than those in the control group separately [7 days：（9.73±6.43） points vs. （12.63± 7.87） points, t =2.28, P〈 0.05;28 days：（7.88±4.81） points vs. （9.84±7.03）points, t =2.04, P〈 0.05]. Barthel index on 7 and 28 days after therapy in the treatment group were higher than those in the control group separately [7 days：（54.28±8.38） points vs. （39.76±7.31） points, t =2.206, P 〈 0.05; 28 days： （89.72±7.94） points vs. （67.34±8.63） points, t =2.812, P 〈 0.01]. （4） Patients were allocated into different age groups based on age and evaluated with LOTCA. Results showed that there were no significant differences among different age groups （P 〉 0.05）. （5） Totally 160 patients in the two groups accomplished the Hopkin＇s test, among them, 94 （58.7%） had different mental disorders; Among the patients with mental disorder, depression, obsessive-compulsive and anxiety were found mostly, being 53.8%, 52.5% and 46.2%, respectively. CONCLUSION： （1） Developing stroke rehabilitation unit therapy in the secondary hospital can obviously improve the motor function and activities of daily living of stroke reconvalescents. （2） More than half of the stroke reconvalescents accompany the symptoms of depression, obsessive-compulsive, anxiety and other mental disorders. （3） The cognitive function of stroke reconvalescents is not related to age.展开更多
Of the 700,000 people in the United States who experience a new or recurrent stroke each year,more than 500,000 survive(American Stroke Association,2007)[1]. Occupational therapy practitioners are critical rehabilitat...Of the 700,000 people in the United States who experience a new or recurrent stroke each year,more than 500,000 survive(American Stroke Association,2007)[1]. Occupational therapy practitioners are critical rehabilitation professionals for stroke survivors.展开更多
Introduction: Palliative care, firstly used for chronic diseases, is currently indicated for some acute pathology such as Stroke. Its implementation improves the quality of care for end-of-life patients. The aim of ou...Introduction: Palliative care, firstly used for chronic diseases, is currently indicated for some acute pathology such as Stroke. Its implementation improves the quality of care for end-of-life patients. The aim of our study is to report a series of patients who died in the intensive care stroke unit of Brazzaville. Method: It was a descriptive study of a series of 13 cases of severe stroke, admitted to the intensive care unit of the university hospital of Brazzaville, between January 2015 and December 2017. Sociodemographic, clinical, paraclinical and prognostic variables were studied. Result: The mean age of the patients was 46 ± 11.5 years with a male predominance in 69.2% (n = 9). They were all hypertensive. The motor deficit and consciousness disorder association was the reason for admission in 84.6% (n = 11) and an epileptic seizure of 15.4% (n = 2). The mean NIHSS at admission was 21 ± 5, that of Glasgow 6 ± 3. Stroke was hemorrhagic in 84.6% (n = 11) and malignant infarction in 15.4% (n = 2). All of these patients received invasive resuscitation with assisted ventilation and all died within 8 days of admission. Conclusion: The issue of limitation of care deserves to be debated, and is proposed on a case-by-case basis, in the face of a serious stroke. Therapeutic relentlessness is not only expensive, but also raises the problem of suffering of the individual at the end of life.展开更多
Stroke is a leading cause of disability and death in Australia. There is a clear benefit in caring for stroke patients in stroke care units. Access to these centres is limited particularly in the rural setting. Certif...Stroke is a leading cause of disability and death in Australia. There is a clear benefit in caring for stroke patients in stroke care units. Access to these centres is limited particularly in the rural setting. Certified stroke care units in the private health care setting are also unheard of. The superiority of these units is thought to be due to better adherence to processes of care (early utility of CT scan, allied health input within 24 hours, neurological observations, DVT prophylaxis and appropriate use of antiplatelet and anticoagulant use). We audited care of 100 patients who presented to the St. John of God Hospital (rural private hospital) over a period of 3 years. This included baseline demographics, adherence of processes of care, utility of appropriate investigations, and outcome measures such as discharge destination, level of function at discharge and complication rates. These data were compared with the national stroke report (AuSCR) and adherence to processes of care was compared with the SCOPE study (the first study to establish the benefit of POC). When compared with data from the AuSCR national report 2012, we found a higher mortality rate, an increased rate of disability on discharge, and a mixed adherence to processes of care. We also found a significant proportion of patients (40%) who were eligible to receive thrombolysis but did not. Overall we found that there were significant strengths to be drawn upon in the rural private healthcare setting and a more organised approach could improve outcomes.展开更多
Calculus bovis is commonly used for the treatment of stroke in traditional Chinese medicine. Hyodeoxycholic acid(HDCA) is a bioactive compound extracted from calculus bovis. When combined with cholic acid, baicalin an...Calculus bovis is commonly used for the treatment of stroke in traditional Chinese medicine. Hyodeoxycholic acid(HDCA) is a bioactive compound extracted from calculus bovis. When combined with cholic acid, baicalin and jas-minoidin, HDCA prevents hypoxia-reoxygenation-induced brain injury by suppressing endoplasmic reticulum stress-mediated apoptotic signaling. However, the effects of HDCA in ischemic stroke injury have not yet been studied. Neurovascular unit(NVU) dysfunction occurs in ischemic stroke. Therefore, in this study, we investigated the effects of HDCA on the NVU under ischemic conditions in vitro. We co-cultured primary brain microvascular endothelial cells, neurons and astrocytes using a transwell chamber co-culture system. The NVU was pre-treated with 10.16 or 2.54 μg/mL HDCA for 24 hours before exposure to oxygen-glucose deprivation for 1 hour. The cell counting kit-8 assay was used to detect cell activity. Flow cytometry and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling were used to assess apoptosis. Enzyme-linked immunosorbent assay was used to measure the expression levels of inflammatory cytokines, including interleukin-1β, interleukin-6 and tumor necrosis factor-α, and neurotrophic factors, including brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor. Oxidative stress-related factors, such as superoxide dismutase, nitric oxide, malondialdehyde and γ-glutamyltransferase, were measured using kits. Pretreatment with HDCA significantly decreased blood-brain barrier permeability and neuronal apoptosis, significantly increased transendothelial electrical resistance and γ-glutamyltransferase activity, attenuated oxidative stress damage and the release of inflammatory cytokines, and increased brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor expression. Our findings suggest that HDCA maintains NVU morphological integrity and function by modulating inflammation, oxidation stress, apoptosis, and the expression of neurotrophic factors. Therefore, HDCA may have therapeutic potential in the clinical management of ischemic stroke. This study was approved by the Ethics Committee of Experimental Animals of Beijing University of Chinese Medicine(approval No. BUCM-3-2016040201-2003) in April 2016.展开更多
目的研究重症监护病房(intensive care unit,ICU)围绝经期脑卒中患者神经功能恢复的影响因素。方法选取2022年1月至2025年1月于台州市第一人民医院ICU治疗的98例围绝经期ICU脑卒中患者作为研究对象。按照神经功能恢复情况分为良好组(神...目的研究重症监护病房(intensive care unit,ICU)围绝经期脑卒中患者神经功能恢复的影响因素。方法选取2022年1月至2025年1月于台州市第一人民医院ICU治疗的98例围绝经期ICU脑卒中患者作为研究对象。按照神经功能恢复情况分为良好组(神经功能恢复良好,n=22)与不良组(神经功能恢复不良,n=76)。比较两组患者的一般资料,包括年龄、体质量指数、入院时急性生理及慢性健康状况评估量表(acute physiology and chronic health evaluation,APACHEⅡ)评分、并发症、咽反射、咳嗽反射、脑卒中类型、格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分和序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分。比较两组患者的生化指标,包括白细胞计数、淋巴细胞计数、血小板计数、血红蛋白水平、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)。比较两组患者的围绝经期相关指标,包括雌激素、激素治疗史、生殖衰老分期(STRAW+10)。进行多因素Logistic回归分析,并采用受试者操作特征曲线分析Logistic回归对ICU围绝经期脑卒中患者神经功能的影响因素。结果良好组处于绝经过渡早期患者的APACHEⅡ评分、GCS评分、淋巴细胞计数、BDNF、雌二醇、STRAW+10分期分别为(14.22±2.85)分、(10.45±2.14)分、(1.43±0.32)×10^(9)、(3.65±0.37)μg/L、(89.65±10.63)pmol/L、63.64%(14/22),不良组为(15.96±3.11)分、(9.23±2.02)分、(1.25±0.29)×109、(3.41±0.31)μg/L、(74.82±9.30)pmol/L、60.53%(46/76),差异有统计学意义(χ^(2)/t=2.353、2.462、2.505、3.059、6.376、4.026,均P<0.05)。APACHEⅡ评分(OR=5.223)、GCS评分(OR=0.228)、雌二醇(OR=0.270)、STRAW+10分期(OR=2.598)是ICU围绝经期脑卒中患者神经功能的影响因素(P<0.05)。APACHEⅡ评分、GCS评分、雌二醇、STRAW+10分期对ICU围绝经期脑卒中患者神经功能影响的曲线下面积分别为0.807、0.792、0.762、0.786。结论APACHEⅡ评分、GCS评分、雌二醇、STRAW+10分期是ICU围绝经期脑卒中患者神经功能恢复的影响因素。展开更多
文摘Background Stroke unit is the most effective treatment method to benefit stroke patients. Our study is to evaluate the early effectiveness of a hospital stroke unit (SU). Methods Three hundred and ninety-two patients who had suffered from acute strokes and who were admitted to our hospital between December 2001 and January 2003 were recruited for this controlled study. All patients were sent at random to either the SU or the general ward (GW) for treatment. The following indices were measured by: Barthel Index (BI),National Institute of Health Stroke Scale (NIHSS),Oxford Handicap Scale (OHS). Results The mean change in BI score between the day of admission and the day of discharge was 20.00±24.36 for the SU group and 10.63±23.59 for the GW group. A difference that is statistically significant ( P =0.000). The mean change in NIHSS score was -2.01±6.61 for the SU group and 0.55±7.44 for the GW group. A difference that is also statistically significant ( P =0.000). Finally,the mean change in OHS score was -0.74±1.04 for the SU group and -0.28±0.98 for the GW group,also a statistically significant difference ( P =0.000). Among SU patients,patient satisfaction was higher ( P =0.000),the rehabilitation success rate was higher ( P =0.000),and there were fewer complications ( P =0.000).Conclusion Compared to GW patients,stroke patients treated in a special SU were able to return to normal daily activities earlier,with better social abilities,and have reduced neurological defects,without increasing the overall economic burden.
基金State Administration of Traditional Chinese Medicine Project (04-05LP28)
文摘The evidence-based medicine proved that Stroke Unit （SU） works most effectively on stroke. Since SU is originated and developed in Europe and America, SU therapies are limited to Western medicine. We can make flexible clinical guidelines by combining TCM with the SU and establish SU mode with Chinese characteristics.
文摘BACKGROUND： Acute stroke unit （stroke care unit） is developing in some domestic large-sized hospitals, but most stroke patients need stroke rehabilitation unit therapy, so setting stroke rehabilitation unit in medium-sized comprehensive community hospital （secondary hospital）, where medical facility is relatively insufficient, is a new pathway to satisfy stroke patients. OBJECTIVE： To observe the comprehensive effect of developing stroke rehabilitation unit based on the facility of secondary hospital and its feasibility. DESIGN： Non-randomized concurrent controlled observation SETTING： Department of Neurology, Beijing Longfu Hospital PARTICIPANTS： Totally 264 stroke reconvalescents who suffered stroke for 7 days and received treatment in the Department of Neurology, Beijing Longfu Hospital during June 2003 to June 2005 were involved in the study. All the involved patients were confirmed by CT or MRI. The patients were scored by using Modified Edinbergh-Scandinavia stroke scale （SSS） 〉 16 points. Written informed consents were obtained from all the patients. The patients were assigned into 2 groups according to the willing of patients and their relatives： （1）treatment group, in which, there were 134 patients, 76 males and 58 females, aged 43 to 74 years; cerebral infarction was found in 116 cases and cerebral hemorrhage in 18 cases;（2） control group, in which, there were 130 patients, 66 males and 64 females, aged 45 to 77 years, cerebral infarction was found in 115 cases and cerebral hemorrhage in 15 cases. There were significant differences in baseline data of the patients between two groups. METHODS： A same basic treatment was conducted in the patients of the two groups. （1） Patients in the treatment group admitted to stroke rehabilitation unit and received comprehensive rehabilitation treatment. The rehabilitation flow-sheet： randomization-letting the patients of treatment group go into the unit-making comprehensive assessment in the initial stage-making therapy plan-talking with patients and their other family members-general rehabilitation-making metaphase assessment-adjusting therapy plan-making final assessment-letting the patients discharge and doing follow-up visits. （2） The patients in the control group admitted to common wards, and they were encouraged to do activities by themselves in the early stage, but did not receive rehabilitation training under the instructions from professional physicians. MAIN OUTCOME MEASURES： The following assessments were conducted on admission and 7 and 28 days after admission： （1） Severity of stroke and motor function： scored as 0 to 45 points by SSS, the higher points, the severer damage. （2）Activities of daily living： Evaluated by Barthel index, 110 points in total, 110 points meant normal, 0 point meant extremely poor. （3）Mental status： evaluated by Hopkin＇s symptom scale with a 5-point scoring. The symptom was scored with low to high points. （4）Cognitive function： Quantification measurement was conducted with LOTCA method. The higher points, the better therapeutic effects. RESULTS： （1） Three cases dropped out and one died in the treatment group, 11 cases dropped out and 4 died in the control group. （2）The neurologic impairment points on 7 and 28 days after therapy in the treatment group were lower than those in the control group separately [7 days：（9.73±6.43） points vs. （12.63± 7.87） points, t =2.28, P〈 0.05;28 days：（7.88±4.81） points vs. （9.84±7.03）points, t =2.04, P〈 0.05]. Barthel index on 7 and 28 days after therapy in the treatment group were higher than those in the control group separately [7 days：（54.28±8.38） points vs. （39.76±7.31） points, t =2.206, P 〈 0.05; 28 days： （89.72±7.94） points vs. （67.34±8.63） points, t =2.812, P 〈 0.01]. （4） Patients were allocated into different age groups based on age and evaluated with LOTCA. Results showed that there were no significant differences among different age groups （P 〉 0.05）. （5） Totally 160 patients in the two groups accomplished the Hopkin＇s test, among them, 94 （58.7%） had different mental disorders; Among the patients with mental disorder, depression, obsessive-compulsive and anxiety were found mostly, being 53.8%, 52.5% and 46.2%, respectively. CONCLUSION： （1） Developing stroke rehabilitation unit therapy in the secondary hospital can obviously improve the motor function and activities of daily living of stroke reconvalescents. （2） More than half of the stroke reconvalescents accompany the symptoms of depression, obsessive-compulsive, anxiety and other mental disorders. （3） The cognitive function of stroke reconvalescents is not related to age.
文摘Of the 700,000 people in the United States who experience a new or recurrent stroke each year,more than 500,000 survive(American Stroke Association,2007)[1]. Occupational therapy practitioners are critical rehabilitation professionals for stroke survivors.
文摘Introduction: Palliative care, firstly used for chronic diseases, is currently indicated for some acute pathology such as Stroke. Its implementation improves the quality of care for end-of-life patients. The aim of our study is to report a series of patients who died in the intensive care stroke unit of Brazzaville. Method: It was a descriptive study of a series of 13 cases of severe stroke, admitted to the intensive care unit of the university hospital of Brazzaville, between January 2015 and December 2017. Sociodemographic, clinical, paraclinical and prognostic variables were studied. Result: The mean age of the patients was 46 ± 11.5 years with a male predominance in 69.2% (n = 9). They were all hypertensive. The motor deficit and consciousness disorder association was the reason for admission in 84.6% (n = 11) and an epileptic seizure of 15.4% (n = 2). The mean NIHSS at admission was 21 ± 5, that of Glasgow 6 ± 3. Stroke was hemorrhagic in 84.6% (n = 11) and malignant infarction in 15.4% (n = 2). All of these patients received invasive resuscitation with assisted ventilation and all died within 8 days of admission. Conclusion: The issue of limitation of care deserves to be debated, and is proposed on a case-by-case basis, in the face of a serious stroke. Therapeutic relentlessness is not only expensive, but also raises the problem of suffering of the individual at the end of life.
文摘Stroke is a leading cause of disability and death in Australia. There is a clear benefit in caring for stroke patients in stroke care units. Access to these centres is limited particularly in the rural setting. Certified stroke care units in the private health care setting are also unheard of. The superiority of these units is thought to be due to better adherence to processes of care (early utility of CT scan, allied health input within 24 hours, neurological observations, DVT prophylaxis and appropriate use of antiplatelet and anticoagulant use). We audited care of 100 patients who presented to the St. John of God Hospital (rural private hospital) over a period of 3 years. This included baseline demographics, adherence of processes of care, utility of appropriate investigations, and outcome measures such as discharge destination, level of function at discharge and complication rates. These data were compared with the national stroke report (AuSCR) and adherence to processes of care was compared with the SCOPE study (the first study to establish the benefit of POC). When compared with data from the AuSCR national report 2012, we found a higher mortality rate, an increased rate of disability on discharge, and a mixed adherence to processes of care. We also found a significant proportion of patients (40%) who were eligible to receive thrombolysis but did not. Overall we found that there were significant strengths to be drawn upon in the rural private healthcare setting and a more organised approach could improve outcomes.
基金supported by the National Natural Science Foundation of China,No.81430102(to QGW)
文摘Calculus bovis is commonly used for the treatment of stroke in traditional Chinese medicine. Hyodeoxycholic acid(HDCA) is a bioactive compound extracted from calculus bovis. When combined with cholic acid, baicalin and jas-minoidin, HDCA prevents hypoxia-reoxygenation-induced brain injury by suppressing endoplasmic reticulum stress-mediated apoptotic signaling. However, the effects of HDCA in ischemic stroke injury have not yet been studied. Neurovascular unit(NVU) dysfunction occurs in ischemic stroke. Therefore, in this study, we investigated the effects of HDCA on the NVU under ischemic conditions in vitro. We co-cultured primary brain microvascular endothelial cells, neurons and astrocytes using a transwell chamber co-culture system. The NVU was pre-treated with 10.16 or 2.54 μg/mL HDCA for 24 hours before exposure to oxygen-glucose deprivation for 1 hour. The cell counting kit-8 assay was used to detect cell activity. Flow cytometry and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling were used to assess apoptosis. Enzyme-linked immunosorbent assay was used to measure the expression levels of inflammatory cytokines, including interleukin-1β, interleukin-6 and tumor necrosis factor-α, and neurotrophic factors, including brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor. Oxidative stress-related factors, such as superoxide dismutase, nitric oxide, malondialdehyde and γ-glutamyltransferase, were measured using kits. Pretreatment with HDCA significantly decreased blood-brain barrier permeability and neuronal apoptosis, significantly increased transendothelial electrical resistance and γ-glutamyltransferase activity, attenuated oxidative stress damage and the release of inflammatory cytokines, and increased brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor expression. Our findings suggest that HDCA maintains NVU morphological integrity and function by modulating inflammation, oxidation stress, apoptosis, and the expression of neurotrophic factors. Therefore, HDCA may have therapeutic potential in the clinical management of ischemic stroke. This study was approved by the Ethics Committee of Experimental Animals of Beijing University of Chinese Medicine(approval No. BUCM-3-2016040201-2003) in April 2016.
文摘目的研究重症监护病房(intensive care unit,ICU)围绝经期脑卒中患者神经功能恢复的影响因素。方法选取2022年1月至2025年1月于台州市第一人民医院ICU治疗的98例围绝经期ICU脑卒中患者作为研究对象。按照神经功能恢复情况分为良好组(神经功能恢复良好,n=22)与不良组(神经功能恢复不良,n=76)。比较两组患者的一般资料,包括年龄、体质量指数、入院时急性生理及慢性健康状况评估量表(acute physiology and chronic health evaluation,APACHEⅡ)评分、并发症、咽反射、咳嗽反射、脑卒中类型、格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分和序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分。比较两组患者的生化指标,包括白细胞计数、淋巴细胞计数、血小板计数、血红蛋白水平、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)。比较两组患者的围绝经期相关指标,包括雌激素、激素治疗史、生殖衰老分期(STRAW+10)。进行多因素Logistic回归分析,并采用受试者操作特征曲线分析Logistic回归对ICU围绝经期脑卒中患者神经功能的影响因素。结果良好组处于绝经过渡早期患者的APACHEⅡ评分、GCS评分、淋巴细胞计数、BDNF、雌二醇、STRAW+10分期分别为(14.22±2.85)分、(10.45±2.14)分、(1.43±0.32)×10^(9)、(3.65±0.37)μg/L、(89.65±10.63)pmol/L、63.64%(14/22),不良组为(15.96±3.11)分、(9.23±2.02)分、(1.25±0.29)×109、(3.41±0.31)μg/L、(74.82±9.30)pmol/L、60.53%(46/76),差异有统计学意义(χ^(2)/t=2.353、2.462、2.505、3.059、6.376、4.026,均P<0.05)。APACHEⅡ评分(OR=5.223)、GCS评分(OR=0.228)、雌二醇(OR=0.270)、STRAW+10分期(OR=2.598)是ICU围绝经期脑卒中患者神经功能的影响因素(P<0.05)。APACHEⅡ评分、GCS评分、雌二醇、STRAW+10分期对ICU围绝经期脑卒中患者神经功能影响的曲线下面积分别为0.807、0.792、0.762、0.786。结论APACHEⅡ评分、GCS评分、雌二醇、STRAW+10分期是ICU围绝经期脑卒中患者神经功能恢复的影响因素。
