腔隙性脑梗死病情进展的危险因素分析  

Risk Factors for Progression of Lacunar Infarction

作　　者：陈兰兰[1] 张娴娴[1] 叶青[1] 李晓波[1] 朱艳[1] 徐林根[2] 

机构地区：[1]江苏省苏北人民医院神经内科,江苏扬州225001 [2]复旦大学附属金山医院耳鼻咽喉科,上海201508

出　　处：《中国临床医学》2012年第6期689-691,694,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨腔隙性脑梗死(lacunar infarction,LI)病情进展的危险因素。方法:回顾分析2008年8月—2012年6月江苏省苏北人民医院诊治的258例急性LI患者(MRI弥散加权成像序列中急性梗死病灶的直径≤15 mm)临床资料。患者运动功能按照美国国立卫生研究院脑卒中量表(National Institute of Health stroke scale,NIHSS)评分评价,入院14 d内加重≥1分者纳入进展组(n=38),余为非进展组(n=220)。采用单因素分析和Logistic回归分析得出LI病情进展的危险因素,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析各因素预测的临界值。结果:单因素分析显示,两组患者梗死病灶直径、血小板计数及收缩压(SBP)水平差异均有统计学意义(P<0.05);将这3个因素进一步行Logistic回归分析显示,两组患者脑梗死病灶直径及SBP水平差异有统计学意义(P<0.05,P<0.01)。ROC曲线分析显示,脑梗死病灶直径的曲线下面积(area under curve,AUC)=0.619,S=0.052,95%CI 0.566～0.678,临界值>10 mm;SBP的AUC=0.586,S=0.058,95%CI 0.523～0.646,临界值>165 mmHg;脑梗死病灶直径和SBP是急性LI患者病情进展的危险因素。结论:脑梗死病灶直径>10 mm及SBP>165 mmHg可作为急性LI病情进展的预测因子。Objective：To evaluate the risk factors for progression of lacunar infarction （LI）. Methods：Clinical data of 258 pa- tients with acute LI from Aug 2008 to Jun 2012 were retrospectively analyzed. The diameters of the infarction area in those pa- tients were smaller than 15 mm in diffusion weighted imaging （DWI）. Progressive LI group（n = 38）was defined as the increase of National Institute of Health stroke scale （NIHSS） ≥1 points within 14 days during hospitalization, while other patients con- stituted non-progressive LI group（n = 220）. Single factor analysis and Logistic regression analysis were used to find the risk factors for prognostic progression. Receiver operating characteristic （ROC） curve was used to decide the cut point of risk fac- tors. Results： The infarction size, platelet count and systolic blood pressure （SBP） were of statistically significant difference between the two groups （P〈0.05） in single factor analysis. The infarction size and SBP were of statistically significant diffe- rence between the two groups （P〈0.05, P〈0.01） in Logistic analysis. The area under curve（AUC） of the ROC curve of in- farction size was 0. 619,S= 0. 052,95% CI 0. 566-0. 678,cut point, f0 mm; AUC of the ROC curve of SBP was 0. 586,S= 0. 058,95 % CI 0. 523-0. 646, cut point〉165 mmHg. They were the risk factors for progression of LI. Conclusions： The infarc- tion size （〉10 mm） and SBP （〉165 mmHg） were the risk factors for LI progression.

关 键 词：腔隙性脑梗死 进展 梗死病灶直径 收缩压 

分 类 号：R743[医药卫生—神经病学与精神病学]