缺血性脑卒中进展的相关危险因素分析及血浆Hcy检测联合ESSEN评分对其预测作用  

Analysis of risk factors and plasma homocysteine combined with ESSEN score in predicting progressive stroke

作　　者：邱石[1] 魏衡[2] 赵静[1] 徐依成[1] 王培福[1] 杜继臣[1] 李继来[1] 

机构地区：[1]航天中心医院,北京100049 [2]湖北省新华医院

出　　处：《山东医药》2014年第28期3-6,共4页Shandong Medical Journal

基　　金：中国航天科工集团第二研究院青年创新基金项目(2013年12号)

摘　　要：目的分析急性缺血性脑卒中(IS)进展的相关危险因素,并探讨血浆同型半胱氨酸(Hcy)检测联合ESSEN评分对其预测作用。方法发病24 h内的急性IS患者126例,根据进展性脑卒中(PS)定义分为PS组30例、非PS组96例。比较两组年龄、性别、高血压病史等,多因素分析急性IS进展为PS的相关危险因素。将所有患者以血浆Hcy≤15μmol/L和Hcy>15μmol/L分为正常组和增高组,两组以ESSEN评分≤2分和>2分再分为两组,以血浆Hcy≤15μmol/L且ESSEN评分>2分的患者为基线组,其余组分别与之比较,评价IS进展为PS的发生风险。结果 PS组FIB水平、颈动脉不稳定斑块、颅内大动脉狭窄、吞咽障碍、血浆Hcy水平及ESSEN评分均高于非PS组(P均<0.05),有糖尿病史例数低于非PS组(P<0.05);多因素分析表明,FIB水平、颅内大动脉狭窄、血浆Hcy水平及ESSEN评分是急性IS进展为PS的危险因素(P均<0.05)。血浆Hcy>15μmol/L且ESSEN评分>2分的急性IS患者短期发展为PS的风险较高。结论 FIB水平、颅内大动脉狭窄、血浆Hcy水平及ESSEN评分等是急性IS发展为PS的危险因素,Hcy联合ESSEN评分对预测PS的价值较高。Objective To analyze the risk factors of acute ischemic stroke （ IS） , and to investigate the combined de-tections of plasma homocysteine （Hcy） and ESSEN score in predicting progressive stroke （PS）.Methods Totally 126 patients with acute IS of onset within 24 h were included .According to PS definition , patients were divided into the PS group （30 cases） and non-PS group （96 cases）.The age, gender and history of hypertension in the two groups were com-pared.and multivariate analysis were used to assess the risk factors of acute IS developing into PS .According to Hcy level , all patients were divided into two groups：the normal group （≤15μmol/L） and the increased group （〉15μmol/L） , and then according to ESSEN score ≤2 and 〉2, they were respectively divided into two groups .Hcy level ≤15μmol/L and ESSEN score 〉2 was designed as baseline , other groups were respectively compared with the baseline group to evolve the short-term risk of PS.Results Fibrinogen （FIB） level, unstable carotid plaque, intracranial artery stenosis, dysphagia, Hcy and ESSEN score were higher in the PS group than those in the non-PS group （ all P〈0.05）; the number of cases with diabetes history was less in the PS group than that of the non-PS group （P〈0.05）.Multivariate analysis showed that FIB level, intracranial artery stenosis , Hcy level and ESSEN score in the PS group were higher than those in the non-PS group （all P〈0.05）.Patients with Hcy level 〉15μmol/L and ESSEN score 〉2 had higher short-term risk of PS.Con-clusion FIB level, intracranial artery stenosis , Hcy level and ESSEN score are the risk factors of PS .Hcy combined with ESSEN score in predicting risk of PS has good predictive value .

关 键 词：缺血性脑卒中 进展性脑卒中 同型半胱氨酸 ESSEN评分 

分 类 号：R743.31[医药卫生—神经病学与精神病学]