进展性轻型卒中患者的临床特征及危险因素分析  

Clinical features of progressive minor stroke and analysis for the risk factors

作　　者：王运锋[1] 郑惠之[2] 聂毅 屈战利 龙继发[1] 季一飞[1] WANG Yunfeng;ZHENG Huizhi;NIE Yi;QU Zhanli;LONG Jifa;JI Yifei(Department of Neurology,the Second Clinical College of North Sichuan Medical College/Nanchong Central Hospital,Nanchong,Sichuan 637000,China;Department of Integrated Chinese and Western Medicine,the Second Clinical College of North Sichuan Medical College/Nanchong Central Hospital,Nanchong,Sichuan 637000,China)

机构地区：[1]川北医学院第二临床医学院/南充市中心医院神经内科,四川南充637000 [2]川北医学院第二临床医学院/南充市中心医院中西医结合科,四川南充637000

出　　处：《重庆医学》2020年第1期39-42,48,共5页Chongqing medicine

基　　金：国家自然科学基金项目(81870966)

摘　　要：目的探讨进展性轻型卒中的临床特征,并分析其危险因素。方法回顾性分析276例轻型卒中的临床资料,根据入院后1周内NIHSS评分是否增加4分,分为进展性轻型卒中与非进展性轻型卒中,单因素分析进展性轻型卒中的危险因素。结果11.9%(33/276)的轻型卒中为进展性卒中,其中72.7%(24/33)的患者进展原因不明。进展性轻型卒中患者的初始血糖、糖化血红蛋白水平明显高于非进展性轻型卒中患者(P<0.05)。在TOAST分型方面,进展性轻型卒中的大动脉粥样硬化型较多(55.1%),而非进展性轻型卒中的小动脉闭塞型较多(47.3%,P<0.05)。通过ESSEN评分进行卒中的危险分层,可见进展性轻型卒中患者多为中、高危组,而非进展性轻型卒中多为低危组(P<0.05)。结论入院时的高血糖状态、TOAST分型中的大动脉粥样硬化及ESSEN评分高危是轻型卒中进展的危险因素,需积极干预。Objective To explore the clinical feature of progressive minor stroke and analysis its risk factors.Methods A retrospective investigation of 276 patients with minor stroke was conducted consecutively.The patients were divided into progressive minor stroke and non-progressive minor stroke according to whether the NIHSS score increased by 4 points within 1 week after admission.An univariate analysis was done for the risk factors of the progressive minor stroke patients.Results 11.9%(33/276)of the minor stroke patients was progressive stroke,of which 72.7%(24/33)was unexplained.The initial blood glucose and glycated hemoglobin levels in patients with progressive minor stroke were significantly higher than those in the non-progressive minor stroke patients(P<0.05).In the classification of TOAST,there were more aortic atherosclerosis(55.1%)in progressive minor stroke,and more occlusion in non-progressive minor stroke(47.3%,P<0.05).According to the stroke stratification through ESSEN stroke risk score,the medium and high risk stroke patients were more common in progressive minor stroke,and the low risk ones were more common in non-progressive minor stroke(P<0.05).Conclusion The hyperglycemia before treatment,the large-artery atherosclerosis cause for stroke and high ESSEN score are the risk factors for progressive minor stroke patients,which should be paid more intervention.

关 键 词：卒中 进展性 危险因素 TOAST分型 ESSEN量表 

分 类 号：R743.3[医药卫生—神经病学与精神病学]