Objectives: Stroke is a major cause of morbidity and mortality worldwide. It is increasingly common from the sixth decade, but is particularly tragic when it occurs in young adults. There are limited studies of stroke...Objectives: Stroke is a major cause of morbidity and mortality worldwide. It is increasingly common from the sixth decade, but is particularly tragic when it occurs in young adults. There are limited studies of stroke in young adults in Nigeria. It is against this background that we embarked on this prospective hospital based study to determine the epidemiology, pattern and case fatality rate of stroke in young adults in Abakaliki Southeastern part of Nigeria. Patients and Method: The stroke patients between the ages of 18 - 50 years admitted to the medical wards of a tertiary health centre at Abakaliki Nigeria from 1st August 2012 to 30th April 2019 were consecutively recruited. They were followed up till discharge. Relevant data like biodata, and clinical features of the patients were extracted and analyzed. Results: A total of 983 (males—511, females—472) stroke cases were seen with 197 between 18 - 50 years. One hundred and fifty two (77%) did neuroimaging (mean age—40.7 years). Eighty-eight (57.9%) had Cerebral infarct (males—42, females—46) while 64 (42.1%) had Hemorrhagic stroke (males—35, females—29). For those that had hemorrhagic stroke, 11 (17.2%) were Subarachnoid hemorrhage (SAH) while 52 (82.8%) were Intracerebral hemorrhage (ICH). The identified risk factors range from hypertension, DM, dyslipidemia, alcoholism, cigarette smoking, HIV infection and chronic use of coffee drinks. Sixteen patients died during the admission with case fatality rate of 10.5%. Conclusion: Stroke is actually prevalent in young adults as 1 in every 5 stroke patients seen was a young adult. In addition to the traditional risk factors, HIV/AIDS and chronic use of coffee drinks were also noted as emerging risk factors. There is need for a continuous health education and strong campaign on primary stroke prevention. Also, there is need for training of more neurologists with interest in stroke management and establishing comprehensive stroke centers at national, regional and local levels in order to contend adequately with the rising burden of stoke in young adults.展开更多
目的观察针药并用治疗卒中恢复期自主神经功能障碍的临床疗效,并观察对24 h心率变异性(heart rate variability,HRV)指标的影响。方法将60例卒中恢复期自主神经功能障碍患者随机分为治疗组和对照组,每组30例。对照组采用对症药物治疗,...目的观察针药并用治疗卒中恢复期自主神经功能障碍的临床疗效,并观察对24 h心率变异性(heart rate variability,HRV)指标的影响。方法将60例卒中恢复期自主神经功能障碍患者随机分为治疗组和对照组,每组30例。对照组采用对症药物治疗,治疗组在对照组治疗基础上采用针刺治疗。观察两组治疗前后临床特征量表(clinical feature scale,CFS)评分、24 h HRV指标[窦性R-R间期标准差(standard deviation of normal-to-normal intervals,SDNN)、窦性R-R间期平均值标准差(standard deviation of the average of normal-to-normal intervals,SDANN)、连续差值的均方根(root mean square of successive differences,RMSSD)、相邻两个窦性R-R间期差值>50 ms的个数所占的百分率(percentage of normal-to-normal intervals differing by more than 50 milliseconds,PNN50)、低频(low frequency,LF)功率、高频(high frequency,HF)功率及LF/HF]的变化,并比较两组临床疗效。结果治疗组总有效率为93.3%,高于对照组的73.3%(P<0.05)。治疗后,两组CFS评分均降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组SDNN、RMSSD、日间及夜间LF、HF水平较治疗前升高,且治疗组高于对照组,差异有统计学意义(P<0.05);两组SDANN、日间及夜间LF/HF、PNN50水平与治疗前比较差异无统计学意义(P>0.05),组间比较差异无统计学意义(P>0.05)。结论针药并用能够调节卒中恢复期自主神经功能障碍患者的自主神经平衡,有利于患者自主神经功能的恢复。展开更多
目的探讨大脑脚非对称性比例(asymmetry rate of cerebral peduncle,ARCP)与中老年优势半球卒中后非优势半球在语言、运动功能等方面代偿潜力的相关性。方法回顾性连续收集2022年10月—2024年10月于上海中医药大学附属市中医医院就诊的...目的探讨大脑脚非对称性比例(asymmetry rate of cerebral peduncle,ARCP)与中老年优势半球卒中后非优势半球在语言、运动功能等方面代偿潜力的相关性。方法回顾性连续收集2022年10月—2024年10月于上海中医药大学附属市中医医院就诊的中老年优势半球卒中后复发卒中患者的临床资料。收集患者复发卒中前后的失语商(aphasia quotient,AQ)、Fugl-Meyer运动功能评定量表(Fugl-Meyer motor assessment scale,FMA)评分及ARCP等指标,观察复发卒中前后上述指标的变化。以ARCP≤0.75和ARCP>0.75为分组标准,分析两组患者AQ、FMA评分在复发卒中前后的变化特点及其与ARCP的相关性。结果17例复发卒中患者中,男性7例,女性10例;年龄为51~80岁;左侧复发卒中6例,右侧复发卒中11例;复发出血性卒中2例,缺血性卒中15例;首次卒中至复发卒中的时间间隔为5~12个月。与复发卒中前相比,9例ARCP≤0.75的右侧复发卒中患者中,AQ下降8.5~59.2分,中位下降值为33.5分;右侧肢体FMA评分下降5~47分,中位下降值为22分;左侧肢体FMA评分下降6~50分,中位下降值为24分。4例ARCP≤0.75的左侧复发卒中患者中,AQ下降0~1.2分,中位下降值为0分;右侧肢体FMA评分下降0~8分,中位下降值为2分;左侧肢体FMA评分下降0~2分,中位下降值为1分。2例ARCP>0.75的右侧复发卒中患者中,左侧肢体FMA评分下降(分别由100分降至86分、96分降至91分)。2例ARCP>0.75的左侧复发卒中患者中,1例AQ无变化,1例由96.0分降至76.4分;右侧肢体FMA评分均出现下降(分别由96分降至81分、95分降至72分)。左侧首次卒中后,AQ与ARCP呈正相关(r=0.767,P=0.003);左侧首次卒中后,右侧肢体FMA评分与ARCP呈正相关(r=0.630,P=0.007);右侧复发卒中后,AQ与ARCP呈正相关(r=0.835,P=0.001);右侧复发卒中后,右侧肢体FMA评分与ARCP呈正相关(r=0.773,P=0.005)。结论中老年优势半球卒中后ARCP≤0.75的患者,其语言及运动功能的恢复与非优势半球代偿密切相关。展开更多
目的探讨扩张型心肌病(dilated cardiomyopathy,DCM)患者心电图碎裂QRS波(fragmented QRS complex,fQRS)和心率变异性(heart rate variability,HRV)及左心室射血分数(left ventricular ejection fraction,LVEF)检测评估预后的价值。方...目的探讨扩张型心肌病(dilated cardiomyopathy,DCM)患者心电图碎裂QRS波(fragmented QRS complex,fQRS)和心率变异性(heart rate variability,HRV)及左心室射血分数(left ventricular ejection fraction,LVEF)检测评估预后的价值。方法回顾性分析2020年1月至2023年12月皖南医学院第二附属医院收治的DCM患者59例,根据随访6个月主要不良心血管事件(major adverse cardiovascular events,MACE)发生情况分为预后不良组26例和预后良好组33例。比较两组临床基线资料、fQRS阳性率、HRV、LVEF。HRV时域指标包括正常心搏间隔标准差(standard deviation of normal NN intervals,SDNN)、综合记录中每个5 min段NN间隔平均值的变异度(standard deviation of the averages of NN intervals in all 5 min segments of the entire recording,SDANN)、5 min分段中NN间期差异性的平均标准差指标(mean of the standard deviation of NN intervals for all 5 min segments,SDNN指数)、相邻正常心搏间期变化量的均方根值(root mean square of standard diviation of NN intervals,r-MSSD)、三角指数。采用Spearman/Pearson相关性分析DCM预后与fQRS阳性率、HRV、LVEF的相关性,ROC曲线分析fQRS、HRV及LVEF预测DCM预后的效能。结果与预后良好组比较,预后不良组fQRS阳性率明显升高,SDNN、SDANN、SDNN指数、r-MSSD、三角指数及LVEF明显降低(P<0.01)。相关性分析显示,DCM患者预后不良与fQRS阳性率呈正相关(P<0.01),与SDNN、SDANN、SDNN指数、r-MSSD、三角指数及LVEF呈负相关(P<0.05,P<0.01)。ROC曲线分析显示,fQRS阳性率、SDNN、SDANN、SDNN指数、r-MSSD、三角指数及LVEF预测DCM预后的曲线下面积分别为0.718、0.756、0.762、0.807、0.858、0.805、0.747,各指标联合预测DCM预后的曲线下面积为0.980(P<0.01)。结论fQRS、HRV、LVEF与DCM患者不良预后具有重要相关性,fQRS阳性率、HRV、LVEF联合检测可作为临床评估和预测DCM不良预后的有效标志物。展开更多
文摘Objectives: Stroke is a major cause of morbidity and mortality worldwide. It is increasingly common from the sixth decade, but is particularly tragic when it occurs in young adults. There are limited studies of stroke in young adults in Nigeria. It is against this background that we embarked on this prospective hospital based study to determine the epidemiology, pattern and case fatality rate of stroke in young adults in Abakaliki Southeastern part of Nigeria. Patients and Method: The stroke patients between the ages of 18 - 50 years admitted to the medical wards of a tertiary health centre at Abakaliki Nigeria from 1st August 2012 to 30th April 2019 were consecutively recruited. They were followed up till discharge. Relevant data like biodata, and clinical features of the patients were extracted and analyzed. Results: A total of 983 (males—511, females—472) stroke cases were seen with 197 between 18 - 50 years. One hundred and fifty two (77%) did neuroimaging (mean age—40.7 years). Eighty-eight (57.9%) had Cerebral infarct (males—42, females—46) while 64 (42.1%) had Hemorrhagic stroke (males—35, females—29). For those that had hemorrhagic stroke, 11 (17.2%) were Subarachnoid hemorrhage (SAH) while 52 (82.8%) were Intracerebral hemorrhage (ICH). The identified risk factors range from hypertension, DM, dyslipidemia, alcoholism, cigarette smoking, HIV infection and chronic use of coffee drinks. Sixteen patients died during the admission with case fatality rate of 10.5%. Conclusion: Stroke is actually prevalent in young adults as 1 in every 5 stroke patients seen was a young adult. In addition to the traditional risk factors, HIV/AIDS and chronic use of coffee drinks were also noted as emerging risk factors. There is need for a continuous health education and strong campaign on primary stroke prevention. Also, there is need for training of more neurologists with interest in stroke management and establishing comprehensive stroke centers at national, regional and local levels in order to contend adequately with the rising burden of stoke in young adults.
文摘目的观察针药并用治疗卒中恢复期自主神经功能障碍的临床疗效,并观察对24 h心率变异性(heart rate variability,HRV)指标的影响。方法将60例卒中恢复期自主神经功能障碍患者随机分为治疗组和对照组,每组30例。对照组采用对症药物治疗,治疗组在对照组治疗基础上采用针刺治疗。观察两组治疗前后临床特征量表(clinical feature scale,CFS)评分、24 h HRV指标[窦性R-R间期标准差(standard deviation of normal-to-normal intervals,SDNN)、窦性R-R间期平均值标准差(standard deviation of the average of normal-to-normal intervals,SDANN)、连续差值的均方根(root mean square of successive differences,RMSSD)、相邻两个窦性R-R间期差值>50 ms的个数所占的百分率(percentage of normal-to-normal intervals differing by more than 50 milliseconds,PNN50)、低频(low frequency,LF)功率、高频(high frequency,HF)功率及LF/HF]的变化,并比较两组临床疗效。结果治疗组总有效率为93.3%,高于对照组的73.3%(P<0.05)。治疗后,两组CFS评分均降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组SDNN、RMSSD、日间及夜间LF、HF水平较治疗前升高,且治疗组高于对照组,差异有统计学意义(P<0.05);两组SDANN、日间及夜间LF/HF、PNN50水平与治疗前比较差异无统计学意义(P>0.05),组间比较差异无统计学意义(P>0.05)。结论针药并用能够调节卒中恢复期自主神经功能障碍患者的自主神经平衡,有利于患者自主神经功能的恢复。
文摘目的探讨大脑脚非对称性比例(asymmetry rate of cerebral peduncle,ARCP)与中老年优势半球卒中后非优势半球在语言、运动功能等方面代偿潜力的相关性。方法回顾性连续收集2022年10月—2024年10月于上海中医药大学附属市中医医院就诊的中老年优势半球卒中后复发卒中患者的临床资料。收集患者复发卒中前后的失语商(aphasia quotient,AQ)、Fugl-Meyer运动功能评定量表(Fugl-Meyer motor assessment scale,FMA)评分及ARCP等指标,观察复发卒中前后上述指标的变化。以ARCP≤0.75和ARCP>0.75为分组标准,分析两组患者AQ、FMA评分在复发卒中前后的变化特点及其与ARCP的相关性。结果17例复发卒中患者中,男性7例,女性10例;年龄为51~80岁;左侧复发卒中6例,右侧复发卒中11例;复发出血性卒中2例,缺血性卒中15例;首次卒中至复发卒中的时间间隔为5~12个月。与复发卒中前相比,9例ARCP≤0.75的右侧复发卒中患者中,AQ下降8.5~59.2分,中位下降值为33.5分;右侧肢体FMA评分下降5~47分,中位下降值为22分;左侧肢体FMA评分下降6~50分,中位下降值为24分。4例ARCP≤0.75的左侧复发卒中患者中,AQ下降0~1.2分,中位下降值为0分;右侧肢体FMA评分下降0~8分,中位下降值为2分;左侧肢体FMA评分下降0~2分,中位下降值为1分。2例ARCP>0.75的右侧复发卒中患者中,左侧肢体FMA评分下降(分别由100分降至86分、96分降至91分)。2例ARCP>0.75的左侧复发卒中患者中,1例AQ无变化,1例由96.0分降至76.4分;右侧肢体FMA评分均出现下降(分别由96分降至81分、95分降至72分)。左侧首次卒中后,AQ与ARCP呈正相关(r=0.767,P=0.003);左侧首次卒中后,右侧肢体FMA评分与ARCP呈正相关(r=0.630,P=0.007);右侧复发卒中后,AQ与ARCP呈正相关(r=0.835,P=0.001);右侧复发卒中后,右侧肢体FMA评分与ARCP呈正相关(r=0.773,P=0.005)。结论中老年优势半球卒中后ARCP≤0.75的患者,其语言及运动功能的恢复与非优势半球代偿密切相关。
文摘目的探讨扩张型心肌病(dilated cardiomyopathy,DCM)患者心电图碎裂QRS波(fragmented QRS complex,fQRS)和心率变异性(heart rate variability,HRV)及左心室射血分数(left ventricular ejection fraction,LVEF)检测评估预后的价值。方法回顾性分析2020年1月至2023年12月皖南医学院第二附属医院收治的DCM患者59例,根据随访6个月主要不良心血管事件(major adverse cardiovascular events,MACE)发生情况分为预后不良组26例和预后良好组33例。比较两组临床基线资料、fQRS阳性率、HRV、LVEF。HRV时域指标包括正常心搏间隔标准差(standard deviation of normal NN intervals,SDNN)、综合记录中每个5 min段NN间隔平均值的变异度(standard deviation of the averages of NN intervals in all 5 min segments of the entire recording,SDANN)、5 min分段中NN间期差异性的平均标准差指标(mean of the standard deviation of NN intervals for all 5 min segments,SDNN指数)、相邻正常心搏间期变化量的均方根值(root mean square of standard diviation of NN intervals,r-MSSD)、三角指数。采用Spearman/Pearson相关性分析DCM预后与fQRS阳性率、HRV、LVEF的相关性,ROC曲线分析fQRS、HRV及LVEF预测DCM预后的效能。结果与预后良好组比较,预后不良组fQRS阳性率明显升高,SDNN、SDANN、SDNN指数、r-MSSD、三角指数及LVEF明显降低(P<0.01)。相关性分析显示,DCM患者预后不良与fQRS阳性率呈正相关(P<0.01),与SDNN、SDANN、SDNN指数、r-MSSD、三角指数及LVEF呈负相关(P<0.05,P<0.01)。ROC曲线分析显示,fQRS阳性率、SDNN、SDANN、SDNN指数、r-MSSD、三角指数及LVEF预测DCM预后的曲线下面积分别为0.718、0.756、0.762、0.807、0.858、0.805、0.747,各指标联合预测DCM预后的曲线下面积为0.980(P<0.01)。结论fQRS、HRV、LVEF与DCM患者不良预后具有重要相关性,fQRS阳性率、HRV、LVEF联合检测可作为临床评估和预测DCM不良预后的有效标志物。
