Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background Early neurological deterioration（END）is common after acute ischemic stroke，which contributes to increased functional impairment and mortality in patients. Triglyceride glucose index（TyG index）is an independent predictor of the severity of neurological deficits in patients with acute ischemic stroke and is also associated with early recurrent ischemic lesions，however，its correlation with the incidence of END in recent single subcortical infarction（SSI）hasbeen rarely reported and the correlation remains unclear. Objective To investigate the correlation between TyG index and the incidence of END in patients with recent SSI. Methods A total of 197 patients diagnosed with SSI and admitted within 72 h after symptom onset in the department of neurology，the Third Hospital of Hebei Medical University from 2020 to 2021 were included in the study and divided into the END group（n=45）and non-END group（n=152）based on whether END was developed. The clinical data of the patients were collected and multivariate Logistic regression analysis was used to investigate the correlation between TyG index and the incidence of END in patients with recent SSI. Receiver operating characteristic（ROC）curves were plotted to assess the predictive value of TyG index for END in patients with recent SSI. Results The proportion of patients with diabetes，FBG，TG and TyG index were higher in the END group than the non-END group（P<0.05）. Multivariate Logistic regression showed that elevated TyG index was a risk factor for END in patients with recent SSI〔OR=1.726，95%CI（1.008，2.956），P=0.047〕. On different lesion infarct sites，elevated TyG index was a risk factor for END in SSI patients with basal ganglia as the infarction area〔OR=3.164，95%CI（1.290，7.760），P=0.012〕. Elevated TyG index was not associated with the occurrence of END in SSI patients with centrum semiovale as the infarction area（P>0.05）. The ROC area under the curve（AUC）of TyG index for predicting END in patients with recent SSI was 0.66〔95%CI（0.57，0.75），P=0.001〕，with an optimal cut-off value of 8.61，sensitivity of 0.689 and specificity of 0.638. Patients were divided into those with TyG index ≥ 8.61 and those with TyG index <8.61 according to the optimal cut-off value of TyG index. Compared with those with TyG index<8.61，patients with TyG index ≥ 8.61 had higher proportion of hyperlipidemia and diabetes，as well as higher levels of FBG，TC，TG，LDL and increased proportion of END，with lower age and HDL（P<0.05）. Conclusion TyG index is correlated with END in SSI patients，and increased TyG index is an independent risk factor for END in SSI patients，and the correlation varies depending on the location of the lesion.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-06-09 Cooperative journals: 《中国全科医学》
Abstract： Background Perioperative acute ischemic stroke（POAIS） is a severe complication of surgery，which can increase surgical mortality and reduce patients' quality of life. The pathogeneses are complex and rarely explored，especially in patients with non-small cell lung cancer（NSCLC）. Objective To investigate the influencing factors of POAIS in NSCLC patients and the predictive value of serum uric acid（SUA） on the occurrence of POAIS in NSCLC patients. Methods A total of 25 NSCLC patients admitted to the Fourth Hospital of Hebei Medical University from July 2014 to April 2022，who suffered from POAIS following lung resection were selected as the case group，while 126 patients without POAIS were randomly selected as the control group after matching by age and gender. The preoperative baseline data，intraoperative data and postoperative pathology#2;related data of all patients were collected. Multivariate Logistic regression analysis was performed to explore the influencing factors of POAIS in the NSCLC patients，and the receiver operating characteristic（ROC） curve was plotted to evaluate the predictive value of preoperative SUA on the development of POAIS in NSCLC patients. Results The average age of the 151 patients was （64±7） years，57.62%（87/151） of whom were male. The multivariate Logistic regression analysis showed that SUA was an influencing factor of POAIS in NSCLC patients〔OR=0.990，95%CI（0.982，0.998），P=0.019〕. The ROC curve indicated that the area under the curve（AUC） of SUA to predict POAIS in NSCLC patients was 64%，with an optimal threshold value of 307.4 μmol/L，sensitivity and specificity of 58.7% and 76.0%，respectively. Conclusion Preoperative SUA level can serve as an independent predictor of POAIS incidence in NSCLC patients. Higher SUA levels at baseline may predict a lower risk of POAIS.
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