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Stroke:老年缺血性卒中患者生存与恢复的相关因素分析!

2017-05-20 xing.T MedSci原创

肢体功能指标-步行速度和握力与缺血性卒中后生存和恢复密切相关。炎症、肾功能和虚弱似乎也是缺血性卒中后生存和恢复的决定因素。

导致老年人卒中后恢复不良的因素鲜为人知。近日,卒中领域权威杂志Stroke上发表了一篇研究文章,在这项研究中,研究人员试图评估卒中前虚弱和相关因素指标作为缺血性卒中后易发生不良结局的标志。

在65岁至99岁发生了缺血性卒中的心血管健康研究参与者中,研究人员评估了几种卒中前评估的危险因素(虚弱、C反应蛋白、白细胞介素-6和胱抑素C)与脑卒中生存结局、认知能力下降(改良迷你精神状态检查≥5分)和日常生活活动下降(增加限制)。

在717例有生存数据的缺血性脑卒中患者中,研究人员发现步行速度慢、握力低和胱抑素C与生存时间较短独立相关。在<80岁的参与者中,虚弱和白细胞介素-6也与生存时间较短相关。在509名有恢复数据的患者中,行走速度慢、低握力与卒中后日常生活活动和认知有关。只有在男性中C-反应蛋白和白细胞介素-6与卒中后认知功能下降相关。只有在女性中虚弱状态与日常生活能力下降相关。

肢体功能指标-步行速度和握力与缺血性卒中后生存和恢复密切相关。炎症、肾功能和虚弱似乎也是缺血性卒中后生存和恢复的决定因素。

原始出处:

Divya Thekkethala Winovich, et al. Factors Associated With Ischemic Stroke Survival and Recovery in Older Adults.Stroke. 2017. https://doi.org/10.1161/STROKEAHA.117.016726

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objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun May 21 05:43:44 CST 2017, time=2017-05-21, status=1, ipAttribution=)]
    2017-05-29 1e15ab67m20(暂无匿称)

    学习了,谢谢分享

    0

  7. 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likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72529, encryptionId=4159e25296d, topicName=相关因素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=19655942413, createdName=zzc2213, createdTime=Mon May 22 02:13:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200730, encodeId=0f9c200e30b8, content=这样的研究都可以发stroke,再次说明随访的重要性, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Sun May 21 08:18:53 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200645, encodeId=e1e0200645ac, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun May 21 05:43:44 CST 2017, time=2017-05-21, status=1, ipAttribution=)]
    2017-05-23 为你把脉

    唱唱歌刚刚古古怪怪

    0

  8. 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likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161022/IMG580B7CD75AF441614.jpg, createdBy=8e901969896, createdName=1e15ab67m20(暂无匿称), createdTime=Mon May 29 21:36:42 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201639, encodeId=d11720163963, content=唱唱歌刚刚古古怪怪, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b0171930782, createdName=为你把脉, createdTime=Tue May 23 11:07:09 CST 2017, time=2017-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457465, encodeId=14dd145e465ba, content=<a href='/topic/show?id=4159e25296d' target=_blank style='color:#2F92EE;'>#相关因素#</a>, beContent=null, objectType=article, channel=null, level=null, 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objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun May 21 05:43:44 CST 2017, time=2017-05-21, status=1, ipAttribution=)]
  9. [GetPortalCommentsPageByObjectIdResponse(id=1806149, encodeId=cb841806149f2, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Sat Sep 02 23:13:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892869, encodeId=0dd918928691f, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, 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objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun May 21 05:43:44 CST 2017, time=2017-05-21, status=1, ipAttribution=)]
    2017-05-21 baihao215

    这样的研究都可以发stroke,再次说明随访的重要性

    0

  10. 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likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161022/IMG580B7CD75AF441614.jpg, createdBy=8e901969896, createdName=1e15ab67m20(暂无匿称), createdTime=Mon May 29 21:36:42 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201639, encodeId=d11720163963, content=唱唱歌刚刚古古怪怪, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b0171930782, createdName=为你把脉, createdTime=Tue May 23 11:07:09 CST 2017, time=2017-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457465, encodeId=14dd145e465ba, content=<a href='/topic/show?id=4159e25296d' target=_blank style='color:#2F92EE;'>#相关因素#</a>, beContent=null, objectType=article, channel=null, level=null, 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objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun May 21 05:43:44 CST 2017, time=2017-05-21, status=1, ipAttribution=)]
    2017-05-21 changjiu

    学习了,谢谢分享。

    0

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病史采集又称为问诊,即是医生通过对患者或患者家属系统的询问疾病的发生、发展过程而获取的病史资料,经过综合分析而做出的临床判断的一种诊断方法。问诊是病史采集的主要手段。病史的采集配合系统的体格检查,即可提出初步的诊断。 详尽的病史采集是体检和各种先进的检查无法代替的,临床上很多疾病可以通过问诊而获得初步诊断。忽视病史采集,容易造成疾病的漏诊和误诊。它是每一位临床医生必须掌握的基本技能,临床疾病的诊断

Circulation:80岁以上的收缩压变化轨迹、虚弱状态和全因死亡率

在生命最后两年SBP的下降表明,如果血压值较低的参与者更接近生命尽头,非随机流行病学的低SBP和高死亡率有关可能有逆向因果关系。

Nat Med:Δ9-THC可以减轻老年认知功能下降!

因此,在中老年个体中恢复CB1信号通路是治疗老年性认知障碍的有效策略。

BMJ:红皮病的重要原因-案例报道

在老年人红皮病的鉴别诊断上,除了更常见的原因,包括牛皮癣、湿疹和药物反应外,应重点考虑挪威疥又称结痂性疥疮或角化性疥疮。疥疮典型的皮肤症状可以缺失,如隧道皮损,生殖器上的结节,广泛的结痂斑块,瘙痒。

老年早期肺癌射靶刀救助公益项目启动

近日,中日医院、北京中慈公益基金会发起的“老年早期肺癌立体定向放疗(射靶刀)救助”公益项目启动会在北京举行。该项目将对经济状况困难、需要进行立体定向放射治疗的老年早期肺癌患者,一次性补助立体定向放疗费3150元。中国工程院院士、中日医院院长王辰在启动会上指出,我国肺癌发病形势严峻,早诊早治是提高肺癌患者生存的关键。在肺癌治疗方面,中日医院正在形成自己的特色,放射肿瘤科在老年早期肺癌立体定向放疗方面

Stroke:老年房颤患者该不该采用抗凝治疗进行二级预防?

在这项研究中考虑到患者的特点,仍有空间使更多的患者采用抗凝剂治疗,而不增加出血。在90岁以上的患者中,出血有所增加,但这并不影响这个年龄阶层的整体结局。

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