脑卒中患者预后不良的危险因素分析  

Risk factors of unfavourable prognosis in patients with stroke

作　　者：林卫[1] 全雪梅[1] 朱希[1] 江文宇[1] 

机构地区：[1]广西壮族自治区江滨医院广西壮族自治区第三人民医院神经内科,南宁530021

出　　处：《中国医学前沿杂志（电子版）》2016年第12期84-88,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：广西壮族自治区卫计委课题资助项目(Z2010116)

摘　　要：目的探究脑卒中患者预后不良的危险因素。方法回顾性分析本院2011年1月至2015年2月收治的156例脑卒中住院患者的临床资料,对所有患者进行跟踪随访,并采用改良Rankin量表(modified Rankin scale,MRS)评估患者预后,采用Logistic回归分析筛选脑卒中患者预后不良的危险因素。结果 156例脑卒中住院患者预后良好90例,预后不良66例,预后良好组和预后不良组患者的性别、年龄、受教育程度、既往高血压病史、糖尿病病史、脑卒中病史、并发症、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、格拉斯哥昏迷评分(Glasgow coma score,GCS)、蒙特利尔认知评估量表(Montreal cognitive assessment,Mo CA)评分、简易精神状况检查(mini-mental state examination,MMSE)评分、白细胞计数、血尿素氮水平、血糖水平、发病至入院时间、住院时间比较均存在明显差异(P<0.05)。多因素Logistic回归分析显示:年龄、受教育程度、脑卒中病史、糖尿病病史、NIHSS评分、住院时间、GCS与脑卒中患者预后相关,其中受教育程度为保护因素,其余均为危险因素,且Mo CA评分、MMSE评分、住院时间的危险度较高(OR分别为6.711、6.013、5.697,P<0.05)。结论年龄、受教育程度、脑卒中病史、糖尿病病史、NIHSS评分、住院时间、GCS与脑卒中住院患者预后密切关联,其中,受教育程度为保护因素,脑卒中病史、糖尿病病史、NIHSS评分、Mo CA评分、MMSE评分、住院时间、GCS均为独立危险因素。Objective To explore the risk factors of unfavourable prognosis in patients with stroke. Method A retrospective analysis of the clinical data of 156 patients with stroke were conducted in our hospital from January 2011 to February 2015. All patients were followed up, and the modified Rankin scale （mRS） was used to evaluate the prognosis in patients. Logistic regression analysis were conducted to find risk factors of unfavourable prognosis in patients with stroke. Result There were 90 patients with stroke had favourable prognosis, and there were 66 patients had poor prognosis. The gender, age and education level, history of hypertension, history of diabetes, history of stroke, complications, National Institutes of Health Stroke Scale （NIHSS） score, Glasgow coma score （GCS）, Montreal cognitive assessment （MoCA） score, mini-mental state examination （MMSE） score, white blood cell count, the level of blood urea nitrogen, level of blood glucose, onset to admission time, length of stay of favourable prognosis and unfavourable prognosis group had significant differences （P ~ 0.05）. Logistic regression analysis showed that age, educational level, history of stroke, history of diabetes, NIHSS score, length of stay, GCS score were associated with prognosis in patients with stroke. The educational level was a protective factor and the rest were risk factors, the risk of MoCA score, MMSE score, length of stay were high （OR = 6.711, 6.013, 5.697, P 〈 0.05）. Conclusion＇ The age, educational level, history of stroke, history of diabetes, NIHSS score, GCS score, length of stay are closely related to the prognosis in patients with stroke. The educational level was a protective factor, history of stroke, history of diabetes, NIHSS score, MoCA score, MMSE score, length of stay, GCS score are the independent risk factors.

关 键 词：脑卒中 预后 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]