进展性缺血性卒中危险因素的分析  

Analysis of the risk factors lead to progressive ischemic stroke

作　　者：林晓东[1] 赵丽[1] 田小卫[1] 李福学[1] 王学敏[1] 

机构地区：[1]秦皇岛市第二医院神经内科,066600

出　　处：《中国脑血管病杂志》2007年第4期152-155,共4页Chinese Journal of Cerebrovascular Diseases

基　　金：河北省科学研究与发展指导计划资助项目[0627611040]

摘　　要：目的探讨引起进展性缺血性卒中(PIS)的危险因素。方法选取PIS患者110例,采用随机数字表法抽取同期住院治疗的急性脑梗死患者110例作为对照组。对两组患者的年龄、性别、既往高血压史、糖尿病史、冠心病史、卒中家族史、卒中次数、短暂性脑缺血发作(TIA)史、吸烟、饮酒等共20个因素进行2χ或t检验,并用多元Logistic回归分析来确定其影响程度。结果单因素分析:①有高血压病史者,PIS组73例(66%),非PIS组35例(32%),P<0.01。②有糖尿病史者,PIS组46例(42%),非PIS组9例(8%),P<0.01。③入院时高血糖者,PIS组51例(46%),非PIS组13例(12%),P<0.01。④卒中发生于椎-基底动脉系统者,PIS组31例(28%),非PIS组9例(8%),P<0.01。⑤入院时感染发热者,PIS组17例(16%),非PIS组5例(4%),P<0.05。⑥有冠心病史者,PIS组17例(16%),非PIS组5例(4%),P<0.05。⑦有TIA发作史者,均发生在PIS组,P<0.05。⑧入院神经功能缺损评分,PIS组为7±4,非PIS组为5±4,P<0.05。将20个因素中具有统计学意义的8个因素进行多元Logistic回归分析,以α=0.05水平为界,将具有统计学意义的4个危险因素依次排列顺序为,既往糖尿病史、入院时感染发热、既往高血压史、有TIA发作史。此4个因素可进入回归模型。结论糖尿病、合并感染、高血压和TIA是PIS的主要危险因素,并且PIS的发生可能是多种因素、多种机制共同作用的结果。Objective To investigate the risk factors lead to progressive ischemic stroke （PIS）. Methods One hundred and ten patients with PIS were selected as the PIS group, and another 110 patients with acute cerebral infarction were selected as the control group by using random digits table at the same period of hospitalization. A total of 20 risk factors, including sex, age, history of hypertension, diabetes, coronary heart disease, stroke family, stroke frequency, transient ischemic attack （TIA）, smoking, and alcoholic consumption, etc. were analyzed with chi-square test or t test, and their affected degree was determined with multiple logistic regression analysis. Results Single factor analysis： Among the 220 patients in both groups, 108 had a history- of hypertension, 73 （66%） in the PIS group, and 35 （32%） in the control group （P 〈0. 01 ） ; 55 patients had a history of diabetes, 46 （42%） in the PIS group, and 9 （8%） in the control group （P 〈0.01 ） ; 64 patients had hyperglycemia on admission, 51 （46%） in the PIS group, and 13 （ 12% ） in the control group （ P 〈 0. 01 ） ; 40 patients occurred in the vertebrobasilar system, 31 （28%） in the PIS group, and 9 （8%） in the control group （P 〈 0. 01 ） ; 22 patients had a fever on admission because of infection, 17 （16%） in the PIS group, and 5 （4%） in the control group （P 〈 0.05） ; 22 patients had a history of coronary heart disease, 17 （16%） in the PIS group, and 5 （4%） in the control group （ P 〈 0. 05 ） ; 9 patients had a history of TIA, and all of them developed P1S （ P 〈 0. 05 ） ;and neurological scores （x^- ±s） on admission were 7. 10 ±3.77 in the PIS group, and 5.40 ±4. 27 in the control group （P 〈 0. 05）. Of the 20 risk factors, 8 had statistical significance, which were futher dealt with multiple logistic regression analysis. The result showed that according to the order of the size of stand- ard partial regression coefficient, the 4 risk factors with statis

关 键 词：脑缺血 脑血管意外 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]