影响急性缺血性脑卒中患者病情恶化的危险因素分析  

Risk factors that worsened the pathologic course of acute ischemic stroke

作　　者：陈靖[1] 殷宇慧[1] 王劭恒[2] 

机构地区：[1]首都医科大学附属北京世纪坛医院神经内科,北京100038 [2]首都医科大学附属北京世纪坛医院麻醉科,北京100038

出　　处：《重庆医学》2014年第19期2420-2422,2425,共4页Chongqing medicine

基　　金：北京世纪坛医院国自然青年博士基金(2012-QB10)

摘　　要：目的探讨影响急性缺血性脑卒中患者病情恶化的危险因素。方法回顾性分析该院神经内科收治的264例急性缺血性脑卒中患者的临床资料。根据患者病情的转归分为恶化组70例和非恶化组194例。通过自制的调查表格收集患者的临床资料、相关实验室检查结果。对比两组患者的各项临床指标,并通过多元线性回归得出影响急性缺血性脑卒中患者病情恶化的危险因素。结果恶化组42.86%有高脂血症病史,70.00%有糖尿病病史,均显著高于非恶化组(P<0.05)。恶化组血糖、糖化血红蛋白、纤维蛋白原、血清铁蛋白、C反应蛋白、低密度脂蛋白胆固醇的水平均显著高于非恶化组(P<0.05)。多元线性回归分析显示,有高脂血症病史及C反应蛋白、低密度脂蛋白胆固醇水平高是影响急性缺血性脑卒中患者病情恶化的独立危险因素。结论临床可根据这些因素评估患者病情,并制订有针对性的措施以改善患者的预后。Objective To investigate the risk factors that worsened the pathologic course of acute ischemic stroke. Methods The clinical data of 264 patients with acute ischemic stroke treated in Shijitan hospital were analyzed retrospectively. According to the outcome,the patients were divided into deterioration group（70 cases） and improved group（194 cases）. The clinical data,labora- tory examination results of the patients were collected through self-made survey and compared between the two groups. The risk factors that worsened the pathologic course of acute ischemic stroke were analyzed by multiple linear regression. Results There were 42.86 M patients with hyperlipidemia history and 70.00 G with diabetes history in the deterioration group, which were signifi- cantly higher than the improved group（P^0.05）. The levels of glucose, glycosylated hemoglobin, fibrinogen, serum ferritin, C reac- tive protein,low density lipoprotein cholesterol in the deterioration group were significantly higher than those in the improved group （P%0.05）. Multiple linear regression analysis showed that hyperlipidemia history, high level of C reactive protein, and high level of low density lipoprotein cholesterol were the independent risk factors that worsened the pathologic course of acute ischemic stroke. Conclusion Hyperlipidemia history,high level of C reactive protein,and high level of low density lipoprotein cholesterol were the independent risk factors that worsened the pathologic course of acute ischemic stroke. According to these factors, patients were e valuated and targeted measures were made to improve the prognosis of the patients.

关 键 词：急性缺血性脑卒中 病情恶化 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]