脑梗死患者早期神经功能恶化的影响因素  

Factors influencing cerebral infarction patients with early neurological deterioration

作　　者：张颖[1] 王蕾[2] 衣晶[1] 秦鼎[1] 张玉林[3] 

机构地区：[1]北京京煤集团总医院神经内科,北京102300 [2]北京京煤集团总医院检验科,北京102300 [3]首都医科大学附属北京佑安医院神经内科,北京100069

出　　处：《西部医学》2016年第6期790-793,共4页Medical Journal of West China

基　　金：国家自然科学基金(81371399);国家十二五重大科技专项基金(2012ZX10001-002;2012ZX10001-003;2012ZX10001-004)

摘　　要：目的探讨影响脑梗死患者早期神经功能恶化（END）的因素。方法选取2010年11月-2012年10月在我院神经内科接受治疗的脑梗死患者96例作为研究对象,采用回顾性分析方法,通过单因素和多因素的Logistics回归分析恶化组34例与非恶化组62例患者的临床资料,探讨影响脑梗死患者END的相关因素。结果 96例脑梗死患者中发生END的共34例,发生率为35.42%。两组患者在性别、年龄、体重指数、冠心病、吸烟史、饮酒史、空腹血糖、纤维蛋白原、高密度脂蛋白胆固醇、甘油三酯、低密度脂蛋白胆固醇、血清总胆固醇和部分凝血酶原时间等方面,差异不具有统计学意义（P〉0.05）;但在NIHSS评分、颈动脉狭窄≥50%比例、糖尿病、高血压的患病比例及心房颤动等方面差异均有统计学意义（均P〈0.05）。Logistics多因素回归分析显示,患者入院时的NIHSS评分、糖尿病、高血压、颈动脉狭窄≥50%和心房颤动都是发生END的重要危险因素（均P〈0.05）。结论脑梗死患者END的发生是多种因素共同作用的结果,早期的临床评定和相关危险因素的护理干预对防治END的发生具有重要的临床意义。因此要求医护人员密切监测脑梗死患者入院时的各项生命体征,对存在体温、血压及血糖升高等的高危患者应引起重视,及时发现病情变化并报告医生,给予积极的干预措施,以阻止脑梗死END的发生;帮助改善患者预后水平,降低致残率和致死率。Objective To explore the factors influencing cerebral infarction patients with early neurological deterioration.Methods Clinical data of 96 patients with cerebral infarction were retrospectively analyzed.By univariate and multivariate regression analysis,deterioration group（34cases）and non-degraded group（62cases）were include to explore the relevant factors of cerebral infarction patients with early neurological deterioration（END）.Results Of 96 cases of cerebral infarction,there were 34cases（35.42%）with END.The gender,age,body weight,heart disease,smoking history,drinking history,fasting blood glucose,triglycerides,high density lipoprotein protein cholesterol,LDL cholesterol,fibrinogen,prothrombin time and partial serum total cholesterol were not related to END（P〈0.05）.NIHSS score,carotid artery stenosis≥50% proportion,diabetes,hypertension and atrial fibrillation aspect ratio were related to END（P〈0.05）.Multivariate analysis showed that NIHSS score,diabetes,hypertension,atrial fibrillation and carotid artery stenosis≥50% were important risk factors for END（P〈0.05）.Conclusion Cerebral infarction patients with early neurological deterioration is the result of many factors,and early clinical evaluation and risk factors associated with nursing intervention has important clinical implications for prevention of the occurrence of END.

关 键 词：脑梗死 早期神经功能恶化 影响因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]