Humans ; Hypoplastic Left Heart Syndrome

Objective To study the relationship between apolipoprotein AI (ApoAI) gene rs12721026 polymorphism and cerebral hemorrhage.Methods One hundred and eighty patents with cerebral hemorrhage,admitted to our hospital from May 2014 to June 2015,were enrolled as ICH group,and 100 normal subjects were chosen as control group.ApoAI gene polymorphisms and related serum lipid parameters of the patients between the two groups were compared.Results The frequency of ApoA I gene polymorphism rs 12721026 alleles G and T in the ICH group showed no significant difference as compared with that in the control group (P＞0.05).The total cholesterol (TC) and triglyceride (TG) levels in the ICH group were significantly higher than those in the control group (P＜0.05),and high density lipoprotein cholesterol (HDL-C) level in the ICH group was significantly lower than that in the control group (P＜0.05);There was no statistically significant difference on the low density lipoprotein cholesterol (LDL-C),ApoAI and lipopolysaccharide (Lp) levels between the ICH group and control group (P＞0.05).In the ICH group,the TC,TG,LDL-C,ApoAI and Lp levels showed no significant difference between TT and GG/TG rs12721026 genotypes (P＞0.05);HDL-C level ofTT genotype was significantly lower than that of GG/TG genotype (P＜0.05).Conclusion ApoAI gene rs12721026 polymorphism shows no obvious role in the pathogenesis of cerebral hemorrhage,but may be associated with reduced HDL-C level.

Objective To study the associations of acute cerebral infarction after spontaneousintracerebral hemorrhage (ICH) with white matter lesions (WMLs),cerebral artery stenosis and bloodpressure (BP) variability.Methods One hundred and fifty-five acute ICH patients,consecutivehospitalized within 24 h of onset from March 2012 to September 2015,were chosen;they were dividedinto infarction after ICH group and non-infarction after ICH group according to hyperintensities remotefrom the hematoma by magnetic resonance diffusion-weighted imaging (DWI) within 4 weeks of onset;according to positions of hemorrhage,they were divided into lobar hemorrhage group and non-lobarhemorrhage group;according to reduction range of mean arterial pressure (MAP) one h within admission,they were divided into intensive BP lowering group (MAP lowering by ≥20％) and non-intensive BPlowering group (MAP lowering＜20％).The clinical and radiological characteristics were analyzed toinvestigate the role of WMLs,cerebral artery stenosis and BP variability in acute cerebral infarction after spontaneous ICH.Results Ischcmic infarcts were detected in 36 of 155 patients (23.2％),mostly located at ipsilateral subcortical cortex;80.6％ of them were asymptomatic infarct and 66.7％ of them were lacunar infarcts.Positions of hemorrhage and severity of leukoaraiosis were significantly different between infarction after ICH group and non-infarction after ICH group (P＜0.05),while the cerebral artery stenosis was not significantly different between the two groups (P＞0.05).Stratified analysis showed that leukoaraiosis in patients from infarction after lobar ICH group was significantly severer than that in those from non-infarction after lobar ICH group (P＜0.05),and the cerebral artery stenosis in patients with infarction after non-lobar ICH was significantly severer than that in those with non-infarction after non-lobar ICH (P＜0.05).Intensive BP lowering patients with cerebral artery stenosis ≥ 50％ group had significantly increased risks of acute ischemic infarcts as compared with intensive BP lowering patients with cerebral artery stenosis＜50％ group,non-intensive BP lowering patients with cerebral artery stenosis ≥ 50％ group,and non-intensive BP lowering patients with cerebral artery stenosis＜50％ group,respectively (P＜0.05).Multivariate Logistic regression analysis showed that lobar hemorrhage and moderate to severe leukoaraiosis were independent risk factors of cerebral infarction after ICH (OR=2.484,95％CI:1.037-5.953,P=0.041;OR=2.426,95％CI:1.045-5.629,P=0.039).Conclusion Cerebral infarction after ICH is mainly associated with cerebral small vessel diseases,intensive BP lowering is associated with high risk of acute ischemic infarcts in patients with atherosclerotic large artery stenosis,and individualized BP control may maximumly reduce secondary brain injury after ICH.