牙齿缺失对急性缺血性卒中患者预后影响的临床研究  

A clinical research on tooth loss and the prognosis of acute ischemic stroke

作　　者：唐爱群 朱瑾华[2] 朱飞奇 

机构地区：[1]广东省深圳市罗湖区干部保健委员会办公室,广东深圳518023 [2]汕头大学医学院附属粤北人民医院神经内科,广东韶关512026

出　　处：《分子诊断与治疗杂志》2015年第3期180-184,共5页Journal of Molecular Diagnostics and Therapy

基　　金：深圳市科技研发资金知识创新计划基础研究项目(JCYJ20130326111250015)

摘　　要：目的探讨牙齿缺失对急性缺血性卒中患者预后的影响。方法选择2011年10月至2012年6月汕头大学医学院附属粤北人民医院神经内科住院的急性期缺血性卒中患者164例,采集患者的人口学资料、既往病史和牙齿缺失等情况,检测血脂、血糖、同型半胱氨酸、超敏C反应蛋白、白细胞、纤维蛋白原、肌酐等血清学指标,入院3天内完成美国国立卫生研究院卒中量表（NIHSS）评分,出院后每半年及研究截止时通过电话随访评定患者改良Rankin量表（mRS）评分。采用t检验或秩和检验比较各组变量指标,组间频率比较采用卡方检验,并行ROC曲线及Logistic回归分析。结果缺血性卒中预后不良相关因素Logistic单因素分析显示,年龄（OR=1.04,95%CI：1.01~1.07,P=0.02）、肌酐（OR=1.01,95%CI：1.00~1.02,P=0.04）、牙齿缺失数（OR=1.05,95%CI：1.01~1.08,P=0.01）及入院时NIHSS评分（OR=1.22,95%CI：1.12~1.33,P〈0.001）是预后不良的危险因素。而经Logistic多因素分析,校正年龄及其他因素的影响后,仅NIHSS评分（OR=1.24,95%CI：1.11~1.40,P〈0.001）和牙齿缺失数（OR=1.07,95%CI：1.02~1.12,P=0.004）与缺血性卒中预后不良相关。结论牙齿缺失数可能是与NIHSS评分相同,均是影响缺血性卒中预后不良的危险因素。Objective To investigate the result of tooth loss effect on the prognosis of acute ischemic stroke. Methods 164 subjects with acute ischemic stroke were recruited. After admission, the general conditions of patients and medical history were collected, as well as the number of missing teeth. The medical fasting blood tests such as lipids, blood glucose, homocysteine, high-sensitivity C-reactive protein, white blood cells, fibrinogen, and creatinine were undertaken within 24 hours. The severity of stroke evaluated with the national institute of health stroke scale （NIHSS） within three days. Modified rankin scale （mRS） was assessed in the form of telephone follow-up when half-year after discharge and at the end of the study. T test, rank sum test and the chi-square test were employed to compare the differences between groups statistically, and logistic regression analysis was employed for the risk factors screening. Results According to the univariate logistic regression, age （OR = 1.04, 95% CI： 1.01 - 1.07, P = 0.02）, ereatinine （OR = 1.01, 95% CI： 1.00 - 1.02, P = 0.04）, number of tooth loss （OR = 1.05, 95% CI： 1.01 - 1.08, P = 0.01） and NIHSS score （OR = 1.22, 95% CI： 1.12 ~ 1.33, P 〈 0.001） were the risk factors of poor prognosis after stroke. In the multiple logistic regression analysis, number of tooth loss （OR = 1.07, 95% CI： 1.02 ~ 1.12, P = 0.004） and NIHSS score （OR = 1.24, 95% CI： 1.11 ~ 1.40, P 〈 0.001） were included. Conclusions Both of the number of tooth loss and NIHSS score were the risk factors of poor prognosis after stroke.

关 键 词：牙齿缺失 缺血性卒中 预后 改良rankin评分 

分 类 号：R743.3[医药卫生—神经病学与精神病学]