急性脑梗死患者脑动脉狭窄或闭塞后梗死灶体积的影响因素  

Influence factors associate with cerebral infarction volume in patients with acute cerebral infarction following cerebral artery stenosis or occlusion

作　　者：米国青 薛满忠 傅昱[2] 王连辉[1] 马洪颖[3] 

机构地区：[1]唐山市第九医院神经内科,063000 [2]唐山市第九医院MRI室,063000 [3]唐山工人医院神经内科

出　　处：《神经疾病与精神卫生》2016年第4期437-440,共4页Journal of Neuroscience and Mental Health

基　　金：河北省科技厅计划外项目（20140681）

摘　　要：目的：探讨急性脑梗死患者脑动脉狭窄或者闭塞后梗死灶体积的影响因素。方法选取2015年1～12月收入我院神经内科的急性脑梗死患者80例为研究对象，采用 mRS 评分判断患者的临床转归情况，采用 ROC 曲线预测患者临床转归梗死灶体积的最佳切点，采用 Logistic 多因素回归模型分析影响梗死灶体积的因素。结果梗死灶体积≤29．23 ml 时，其临床转归的效果较好，且灵敏度及特异度较高，ROC 曲线下面积为0．997。梗死灶体积≤29．23 ml 组和梗死灶体积＞29．23 ml 组患者，在年龄、NIHSS 评分、白细胞数、血清白蛋白、hs － CRP 、GHbA1c 水平及脑白质疏松程度方面比较，差异有统计学意义（P ＜0．05）。 Logistic 多因素分析显示，血清白蛋白是脑动脉狭窄或者闭塞后梗死灶体积＞29．23 ml 的保护因素（P ＜0．05），GHbA1c 和脑白质疏松程度是危险因素（P ＜0．05）。结论血清白蛋白、GHbA1c 水平和脑白质疏松程度是急性脑梗死患者脑动脉狭窄或者闭塞后梗死灶体积的影响因素。Objective To analyze the influence factors associated with cerebral infarction volume in patients with acute cerebral infarction following cerebral artery stenosis or occlusion .Methods Eighty cases of patients with acute cerebral infarction in my hospital from January 2015 to December 2015 were enrolled .The clinical outcome of the patient was determined by Modify Rankins Scale（mRS） score ,the optimal cut - off value of infarct volume was determined by ROC curves ,and the influencing factors of infarction volume were analyzed by logistic regression model .Results When infarct volume ≤ 29 .23 ml , the clinical outcome was better ,higher sensitivity and specificity ,ROC area was 0 .997 .The differences in age ,NIHSS score ,white blood cell count ,serum albumin ,hs - CRP ,GHbA1c level and the degree of leukoaraiosis were statistically significant （P 〈 0 .05） between the patients with infarct volume ≤29 .23 ml and infarcts volume 〉 29 .23 ml ,Logistic analysis showed that serum albumin level is a protec-tion factor in infarction volume 〉 29 .23 ml ,while the GHbA1c level and degree of leukoaraiosis were risk factors .Conclusions The serum albumin , GHbA1c level and degree of leukoaraiosis are the influence factors associated with infarct volume in patients with acute cerebral infarction following cere-bral artery stenosis or occlusion .

关 键 词：急性脑梗死 脑动脉 梗死灶体积 影响因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]