Clinical analysis of risk factors for progressive stroke

Objective To investigate the risk factors for patients with progressive stroke (PS). Methods The clinical data of 78 patients with PS were analyzed retrospectively, and 72 patients with nonprogressive stroke were selected randomly over the same period of hospitalization as the control group.The blood pressure, glucose, body temperature, peripheral blood leukocytes, lipids, fibrinogen, TCD and carotid duplex ultrasound in patients of the 2 groups were analyzed.Results As compared between the PS group and the control group: ①There was no significant difference in the history of hypertension between the 2 groups.Twenty-seven (34.6%) of the patients whose mean arterial pressure was reduced by 30% with antihypertensive drugs within 24 hours after the symptom onset were in the PS group and 4(5.6%) were in the control group; the difference between the two groups was statistically significant (P 0.01).② There were 51 patients (65.4%) with a history of diabetes in the PS group and 16 (22.2%) in the control group; there was significant difference between the two groups (P 0.01).③ The body temperature of 23 patients (29.5%) was over 37.5℃ after admission in the PS group, and there were 6 patients (8.3%) in the control group.The peripheral blood leukocytes of 45 patients (57.7%) were 10 × 10~9 /L in the PS group, and there were 12 patients (16.7%) in the control group; there was significant difference between the two groups (P 0.01).④56 patients (71.8%) with hyperlipidemia were in the PS group, and 50 (69.4%) were in the control group; there was no significant difference between the two groups (P 0.05).⑤The fibrinogen was 5.1 ±1.8 g/L in the PS group, and it was 2.3 ± 1.4 g/L in the control group; the difference was statistically significant between the 2 groups (P 0.01).⑥The stenosis rate of large blood vessels in both groups was 53.8% and 20.8% , respectively.The difference was statistically significant (P 0.01).The total number of carotid artery plaque detected in the PS group was 68 (87.2%) ; the number of soft plaques was 31 (59.7%) ; and the number of ulcer plaques detected were 33 (42.3%) , while the detection rate of the control group was 69.4% , the number of soft plaque and the detection rate were 16 and 22.2% , respectively; the number of ulcer plaques detected and detection rate were 7 and 9.7%.The difference was statistically significant between the 2 groups (P 0.05).Conclusion Excessive lowering of blood pressure, diabetes, infection, high fibrinogen level, large artery stenosis, and unstable carotid plaque are the risk factors for PS.