老老年急性脑梗死患者的临床特征分析  

Clinical features of the elderly patients over 80 years with cute cerebral infarction

作　　者：凌莉[1] 李小强[1] 张素平[1] 尹义臣[1] 王慕真[1] 何锐[1] 邓婉青[1] 

机构地区：[1]广东省广州市红十字会医院 暨南大学医学院第四附属医院神经内科,510220

出　　处：《中国综合临床》2015年第7期597-600,共4页Clinical Medicine of China

基　　金：国家自然科学基金资助项目（81100898）;广东省自然科学基金资助项目（9451022002003396）

摘　　要：目的探讨老老年（≥80岁）急性脑梗死的危险因素、严重程度和梗死部位的特征。方法选取2012年1月至2015年3月在我院住院的急性脑梗死患者162例，根据年龄分为≥80岁老年组88例和中青年（〈60岁）组74例。对其危险因素、人院时的美国国立卫生研究院脑卒中量表（NIHSS）评分和牛津郡社区脑卒中项目（OCSP）分型进行比较分析。结果≥80岁老年组患者伴冠心病（25．0％，22／88）、心房颤动（13．6％，12／88）高于中青年组[12．2％（9／47）与4．1％（3／74）]，两组比较差异均有统计学意义（χ^2值分别为4．281、4．393，P均〈0．05）；≥80岁老年组患者入院时NIHSS评分[（7．740±4．986）分]高于中青年组[（5．040±4．305）分]，两组比较差异有统计学意义（t=-3．649，P〈0．001）。Logistic回归分析发现：吸烟、高血脂、入院NIHSS评分高和性别（男）是急性脑梗死的独立危险因素（OR值分别为3．851、3．609、1．100、2．670，P均〈0．05）；≥80岁老年组中腔隙性梗死分型比率（40．9％，36／88）低于中青年组（60．8％，45／74），两组比较差异有统计学意义（χ^2=6．369，P〈0．05）。结论与中青年相比，≥80岁老年人发生急性脑梗死时病情更加严重，其危险因素和脑梗死部位等方面有其特殊性。应及时干预〉180岁老年患者脑梗死的危险因素，正确采取有效的防治措施，提高对≥80岁老年脑梗死的治疗效果。Objective To investigate the risk factors, severity and infarct site features and clinical characteristics of the elderly patients over 80 years with cute cerebral infarction. Methods One hundred and sixty-two patients with acute cerebral infarction in Red Cross Hospital of Guangzhou, The Forth Affiliated Hospital of Medical College of Jinan University from January 2012 to May 2015 were enrolled and randomly divided into the elderly patients （ ±〉 80 years old） and the middle aged patients （ 〈 60 years old ）. The risk factors, national institutes of health stroke scale （NIHSS） scores and Oxfordshire community stroke project （OCSP） criteria were compared between the two groups. Results Coronary artery disease, atrial fibrillation and NIHSS in the elderly patients （ 25% （ 22/88 ）, 13.6% （ 12/88 ）, 7. 74 ± 4. 986 ） were significantly higher than those of the middle aged group （ 12. 2% （ 9/47 ） , 4. 1% （ 3/74 ） , 5.04 ± 4. 305 ） , and the differences were significant（χ^2 = 4. 281,4. 393, t =-3. 649 ;P〈0. 05 or P〈0. 001 ）. The logistic regression analysis finally showed that smoking, hyperlipemia, NIHSS scores and gender （ male ） were the independent risk factors （ OR = 3.851, 3. 609,1. 100 and 2. 670;P〈0. 05）. There were more LACI patients in the elderly group than he middle aged group（ （40. 9%,36/88） vs. （ 60. 8% ,45/74）, χ^2 = 6. 369,P〈0. 05）. Conclusion Compare to the middle aged patients, occurrence of the elderly patients with acute cerebral infarction is more severe, and the clinical features and risk factors have its particularity. Secondary prevention strategy should be emphasized on the control of different risk factors based on the patients＇ age.

关 键 词：急性脑梗死 老年人 中青年 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]